Key result
Pre-transplant SERCA2a levels ≥ 0.60 ng/mL predict ~78% lower risk of primary graft dysfunction.
Why the study?
Noninvasive detection of primary graft dysfunction after heart transplantation remains a major challenge, prompting investigation into whether plasma levels of SERCA2a can serve as a biomarker.
Do pre-transplant plasma SERCA2a levels predict primary graft dysfunction in adult heart transplant recipients?
Observational (n=135)
Do pre-transplant plasma SERCA2a levels predict primary graft dysfunction in adult heart transplant recipients?
Pre-transplant plasma SERCA2a levels may serve as a novel noninvasive biomarker to predict the risk of primary graft dysfunction after heart transplantation.
May aid noninvasive PGD risk assessment pre-HT; leaves open clinical utility pending prospective validation.
BACKGROUND: Noninvasive detection of primary graft dysfunction (PGD) remains a major challenge. SERCA2a plays an important role in cardiac homeostasis and its dysregulation has been associated with ventricular dysfunction and rejection. This study aimed to determine the potential utility of plasma levels of SERCA2a as a biomarker of PGD. METHODS: One hundred thirty-five plasma samples were collected from adult recipients 2-6 hours before heart transplantation (HT). Plasma concentrations of SERCA2a were determined using a specific sandwich ELISA. Variables related to the recipient, the donor, and the periprocedural were collected to determine a multivariate predictive model of PGD. RESULTS: Levels of SERCA2a were decreased in patients who developed PGD (median 0.430 ng/mL [interquartile range, 0.260-0.945] versus 0.830 ng/mL [interquartile range, 0.582-1.052]; P = 0.001). Receiver operating characteristic curve analysis revealed that SERCA2a discriminated between patients with and without PGD (AUC = 0.682; P = 0.001), and a cutoff point ≥ 0.60 ng/mL was a protective independent predictor of PGD (odds ratio 0.215 [P = 0.004]). Three independent predictors of PGD in this study were reduced levels of pre-HT SERCA2a, increased bilirubin levels, and short-term mechanical circulatory support bridge to transplantation. The analysis of the receiver operating characteristic curve of the model obtained a significant AUC 0.788, P = 0.0001. CONCLUSIONS: Our findings suggest that assessment of SERCA2a plasma levels may improve risk prediction for the occurrence of PGD and could be considered as a novel noninvasive biomarker in patients undergoing HT.
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A 2021 study conducted an observational in Primary graft dysfunction after heart transplantation (n=135). Pre-transplant SERCA2a plasma levels ≥ 0.60 ng/mL vs. Pre-transplant SERCA2a plasma levels < 0.60 ng/mL was evaluated on Primary graft dysfunction (OR 0.215, p=0.004). Pre-transplant SERCA2a plasma levels ≥ 0.60 ng/mL independently predicted a lower risk of primary graft dysfunction after heart transplantation (OR 0.215; P=0.004).
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