Donor Pericardial Interleukin and Apolipoprotein Levels May Predict the Outcome after Human Orthotopic Heart Transplantation

Author:

Pállinger Éva1,Székely Andrea23ORCID,Töreki Evelin4ORCID,Bencsáth Erzsébet Zsófia5,Szécsi Balázs5ORCID,Losoncz Eszter5,Oleszka Máté4,Hüttl Tivadar3,Kosztin Annamária3ORCID,Buzas Edit I.167ORCID,Radovits Tamás3,Merkely Béla3

Affiliation:

1. Department of Genetics, Cell- and Immunobiology, Semmelweis University, 1085 Budapest, Hungary

2. Department of Anesthesiology and Intensive Therapy, Semmelweis University, 1085 Budapest, Hungary

3. Heart and Vascular Center, Semmelweis University, 1085 Budapest, Hungary

4. Faculty of Medicine, Semmelweis University, 1085 Budapest, Hungary

5. Doctoral School of Theoretical and Translational Medicine, Semmelweis University, 1085 Budapest, Hungary

6. HCEMM-SU Extracellular Vesicle Research Group, Semmelweis University, 1085 Budapest, Hungary

7. ELKH-SE Translational Extracellular Vesicle Research Group, Semmelweis University, 1085 Budapest, Hungary

Abstract

The proinflammatory cascade that is activated at the time of brain death plays a crucial role in organ procurement. Our aim of this study was to explore the relationship between the clinical outcome of orthotopic heart transplantation, as well as cytokine and apolipoprotein profiles of the pericardial fluid obtained at donation. Interleukin, adipokine and lipoprotein levels in the pericardial fluid, as well as clinical data of twenty donors after brain death, were investigated. Outcome variables included primary graft dysfunction, the need for posttransplantation mechanical cardiac support and International Society for Heart and Lung Transplantation grade ≥ 2R rejection. Hormone management and donor risk scores were also investigated. Lower levels of IL-6 were observed in primary graft dysfunction (median: 36.72 [IQR: 19.47–62.90] versus 183.67 [41.21–452.56]; p = 0.029) and in the need for mechanical cardiac support (44.12 [20.12–85.70] versus 247.13 [38.51–510.38]; p = 0.043). Rejection was associated with lower ApoAII (p = 0.021), ApoB100 (p = 0.032) and ApoM levels (p = 0.025). Lower adipsin levels were detected in those patients receiving desmopressin (p = 0.037); moreover, lower leptin levels were found in those patients receiving glucocorticoid therapy (p = 0.045), and higher T3 levels were found in those patients treated with L-thyroxine (p = 0.047) compared to those patients not receiving these hormone replacement therapies. IL-5 levels were significantly associated with UNOS-D score (p = 0.004), Heart Donor Score (HDS) and Adapted HDS (p < 0.001). The monitoring of immunological and metabolic changes in donors after brain death may help in the prediction of potential complications after heart transplantation, thus potentially optimizing donor heart allocation.

Funder

European Union

Ministry of Innovation and Technology of Hungary from the National Research, Development and Innovation Fund

Thematic Excellence Programme of the Ministry for Innovation and Technology in Hungary

National Research, Development and Innovation Office (NKFIH) of Hungary

European Union’s Horizon 2020 Research and Innovation Programme

National Research, Development and Innovation Fund of Hungary

Publisher

MDPI AG

Subject

Inorganic Chemistry,Organic Chemistry,Physical and Theoretical Chemistry,Computer Science Applications,Spectroscopy,Molecular Biology,General Medicine,Catalysis

Reference37 articles.

1. Donor heart selection: Evidence-based guidelines for providers;Copeland;J. Heart Lung Transplant.,2022

2. Donor Utilization in the Recent Era: Effect of Sex, Drugs, and Increased Risk;Baran;Circ Heart Fail.,2022

3. Transplanting Marginal Organs in the Era of Modern Machine Perfusion and Advanced Organ Monitoring;Resch;Front. Immunol.,2020

4. Medical Management of Brain-Dead Organ Donors;Lee;Acute Crit. Care,2019

5. Ludhwani, D., Abraham, J., and Kanmanthareddy, A. (2022). Heart Transplantation Rejection, StatPearls.

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