供体血浆 VEGF-A 作为心脏移植后心肌损伤和原发性移植物功能障碍的生物标记物。

IF 6.4 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
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引用次数: 0

摘要

背景:血管内皮生长因子(VEGF)-A 是一种血管生成和促炎细胞因子,对微血管通透性和血管扩张有深远影响。在脑死亡器官捐献者体内,有几种过程可能会诱导 VEGF-A 的表达。然而,目前仍不清楚供体 VEGF-A 是否与心脏移植后的不良预后有关:我们研究了 83 名心脏移植供体的血浆 VEGF-A 水平,以及这些供体和 2010 年至 2016 年间手术的受体的临床数据。使用基于 Luminex 的多重分析仪对供体血浆进行分析,并使用单靶点 ELISA 进行确认。根据供体VEGF-A血浆水平,受体被分为三个等量组(低VEGF 3000 ng/L,n=27)。对心肌损伤的生化和临床参数以及心脏移植和肾功能进行了为期一年的随访,并对排斥反应、心脏同种异体移植血管病变的发展和死亡率进行了为期五年的监测:除年龄外,各供体组的基线参数相当,低、中、高供体血浆血管内皮生长因子水平组的中位年龄分别为 40 岁、45 岁和 50 岁,因此供体年龄被列为混杂因素之一。高水平的供体血浆血管内皮生长因子-A与明显的心肌损伤(TnT和TnI)、较高的肌力评分以及心脏移植后受体原发性移植物功能障碍的发生率较高有关。此外,血浆血管内皮生长因子-A水平高的供体的异体移植物受者在重症监护室和医院的住院时间更长,接受长期肾脏替代治疗的可能性也更大:我们的研究结果表明,供体血浆 VEGF-A 水平升高与心脏移植受者的不良预后有关,尤其是在心肌损伤、原发性移植物功能障碍和长期肾脏并发症方面。供体血管内皮生长因子-A可作为一种潜在的生物标志物,用于预测这些不良后果和确定延长供体标准。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Donor plasma VEGF-A as a biomarker for myocardial injury and primary graft dysfunction after heart transplantation

Background

Vascular endothelial growth factor (VEGF)-A is an angiogenic and proinflammatory cytokine with profound effects on microvascular permeability and vasodilation. Several processes may induce VEGF-A expression in brain-dead organ donors. However, it remains unclear whether donor VEGF-A is linked to adverse outcomes after heart transplantation.

Methods

We examined plasma VEGF-A levels from 83 heart transplant donors as well as the clinical data of these donors and their respective recipients operated between 2010 and 2016. The donor plasma was analyzed using Luminex-based Multiplex and confirmed with a single-target ELISA. Based on donor VEGF-A plasma levels, the recipients were divided into 3 equal-sized groups (low VEGF <500 ng/liter, n = 28; moderate VEGF 500–3000 ng/liter, n = 28; and high VEGF >3000 ng/liter, n = 27). Biochemical and clinical parameters of myocardial injury as well as heart transplant and kidney function were followed-up for one year, while rejection episodes, development of cardiac allograft vasculopathy, and mortality were monitored for 5 years.

Results

Baseline parameters were comparable between the donor groups, except for age, where median ages of 40, 45, and 50 were observed for low, moderate, and high donor plasma VEGF levels groups, respectively, and therefore donor age was included as a confounding factor. High donor plasma VEGF-A levels were associated with pronounced myocardial injury (TnT and TnI), a higher inotrope score, and a higher incidence of primary graft dysfunction in the recipient after heart transplantation. Furthermore, recipients with allografts from donors with high plasma VEGF-A levels had a longer length of stay in the intensive care unit and the hospital, and an increased likelihood for prolonged renal replacement therapy.

Conclusions

Our findings suggest that elevated donor plasma VEGF-A levels were associated with adverse outcomes in heart transplant recipients, particularly in terms of myocardial injury, primary graft dysfunction, and long-term renal complications. Donor VEGF-A may serve as a potential biomarker for predicting these adverse outcomes and identifying extended donor criteria.

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来源期刊
CiteScore
10.10
自引率
6.70%
发文量
1667
审稿时长
69 days
期刊介绍: The Journal of Heart and Lung Transplantation, the official publication of the International Society for Heart and Lung Transplantation, brings readers essential scholarly and timely information in the field of cardio-pulmonary transplantation, mechanical and biological support of the failing heart, advanced lung disease (including pulmonary vascular disease) and cell replacement therapy. Importantly, the journal also serves as a medium of communication of pre-clinical sciences in all these rapidly expanding areas.
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