Cardiac Troponin I (cTnI) Dynamics After Lung Transplantation and Its Consequences for Early Postoperative Management

BACKGROUND: Myocardial injury with elevated cardiac troponin I (cTnI) is common after cardiac or even thoracic surgery and may indicate impaired prognosis. While cTnI has been monitored after lung transplantation routinely (LuTX), its relevance is to be elucidated. Therefore, this study focused on cTnI dynamics and its prognostic value after LuTX. METHODS: This retrospective study analyzed data from 151 adult patients who underwent a LuTX at a single German lung center between 2005 and 2022. It focused on cTnI levels and dynamics at four postoperative time points, their impact on LuTX outcomes, and possible risk factors for elevated cTnI. RESULTS: Elevated cTnI above the upper limit of normal was a regular finding early after LuTX without independent prognostic value, peaking 5-8 h postoperative. However, a failure to subsequently decrease may indicate a higher risk of mortality. Patients' cTnI levels showed weak positive correlations with duration of mechanical ventilation and length of stay in the intensive care unit. DISCUSSION: Elevated cTnI levels after LuTX might impact patient outcomes. However, larger multi-center studies are needed to conclusively determine their impact.