Troponin T as a marker for posttransplantation adaptational problems of the donor heart.

Background : Troponin T is used as a marker for myocardial cell damage (e.g., in aiding diagnosis and follow-up of myocardial infarction). Elevated troponin T levels are also observed after heart transplantation, although until now no explanation could be found for this phenomenon. Methods and Results : Serum samples of 15 patients who underwent orthotopic heart transplantation were tested for troponin T with a one-step enzyme immunoassay. The highest concentrations of troponin T were seen between day 3 and 14 after transplantation (3.05 ± 1.30 μg/L) and remained elevated up to 3 months. A correlation (r = 0.61, p < 0.02) was found between pretransplantation systolic pulmonary artery pressure and the cumulative troponin T release after transplantation. No association was found with rejection, and no correlation was found with ischemic time of the donor heart. Conditions : These findings support the hypothesis that the acute exposure of the donor heart to the preexisting elevated right ventricular afterload in the recipient represents a strong mechanical stress for the transplanted heart. Measurement of troponin T may therefore be helpful in the posttransplantation monitoring and management of ventricular function after orthotopic heart transplantation.