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Elevated High-Sensitivity Troponin I During Living Donor Liver Transplantation Is Associated With Postoperative Adverse Outcomes

2018; Wolters Kluwer; Volume: 102; Issue: 5 Linguagem: Inglês

10.1097/tp.0000000000002068

1534-6080

Jungchan Park, Seung Hwa Lee, Sangbin Han, Ki-Yoon Kim, Go Eun Kim, Myung‐Soo Park, Suk-Koo Lee, Gyu‐Seong Choi, Soohyun Ahn, Hyeon Seon Ahn, Gaab Soo Kim,

Cardiac Valve Diseases and Treatments

In Brief Background This study aimed to evaluate risk factors and postoperative clinical outcome associated with myocardial injury detected by an elevated high-sensitivity cardiac troponin I (hs-cTnI) immediately after living donor liver transplantation (LDLT). Methods Between January 2011 and December 2016, 313 adult recipients undergoing LDLT, with normal preoperative hs-cTnI were selected. Hs-cTnI level above 0.04 ng/mL according to 99th percentile reference limit was defined as myocardial injury. The recipients were divided into 2 groups according to postoperative hs-cTnI measured immediately after LDLT and postoperative clinical outcome was compared. Results The primary outcome was composite of death or graft failure during hospital stay. Risk factors associated with myocardial injury during LDLT was also evaluated. Of the 313 recipients with normal preoperative hs-cTnI level, 159 (50.8%) had elevated hs-cTnI level and 154 (49.2%) had normal level after LDLT. The incidence of all-cause death or graft failure during hospital stay was significantly higher in recipients with myocardial injury (1.9% vs 7.6%; hazard ratio, 4.15; 95% confidence interval, 1.01-17.14; P = 0.049). The same result was shown in propensity-matched population (0.9% vs 9.0%; hazard ratio, 9.08; 95% confidence interval, 1.16-71.01; P = 0.04). The results during 1-year follow-up were not consistent. Female sex, ischemia time, and presence of postreperfusion syndrome were independent predictors of myocardial injury during LDLT. Conclusions Myocardial injury detected by elevation of hs-cTnI level immediately after LDLT was independently associated with adverse outcome during hospital stay. High Sensitivity Troponin assay has been introduced in liver transplantation in the detection of occult myocardial injury. In this report, Park et al demonstrate an highly increased risk of all-cause mortality in living donor liver transplantation that is associated with this biomarker.