| Donor serum SMARCAL1 concentrations predict primary graft dysfunction in cardiac transplantation. | |
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MedLine Citation:
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PMID: 19752368 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Primary graft dysfunction (PGD) is a life-threatening complication in cardiac transplantation. A sensitive, specific, and easily measurable predictor in donors could facilitate PGD prevention. METHODS AND RESULTS: SMARCAL1 is a matrix-associated regulator of chromatin with helicase and ATPase activities, and its serum concentrations were significantly increased in a targeted protein array in donors whose grafts developed PGD. Therefore, this study analyzed SMARCAL1 serum concentrations by ELISA in 336 heart donors before and after aortic cross-clamping (ACC) and in recipients at 10, 30, and 60 minutes reperfusion. Demographic and hemodynamic parameters of donors and recipients as well as transplant procedure characteristics were documented. PGD (n=68) was defined as ventricular dilation and hypocontractility associated with systolic blood pressure <90 mm Hg, pulmonary capillary wedge pressure >20 mm Hg, and decreased mixed venous oxygen saturation necessitating mechanical circulatory support. SMARCAL1 serum protein concentration was significantly increased only before and after ACC in donors (P<0.0001) whose grafts developed PGD compared to those who did not. In receiver operating characteristic curve analysis, SMARCAL1 serum concentration at a cut-off level of > or =1.25 ng/mL before ACC in donors predicted PGD (P<0.0001, AUC=0.988, OR=17.050, 95% CI=5.200 to 55.901) with 96% sensitivity and 88% specificity. SMARCAL1 serum concentrations <1.25 ng/mL in donors before ACC resulted in 97% PGD-free outcome and SMARCAL1 concentrations > or =1.25 resulted in 83% PGD occurrence. CONCLUSIONS: Donor serum SMARCAL1 may serve as a specific, sensitive, and noninvasive predictive marker in the assessment of cardiac graft quality. |
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Authors:
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Seyedhossein Aharinejad; Olena Andrukhova; Matthias Gmeiner; Anita Thomas; Arezu Aliabadi; Andreas Zuckermann; Katharina Krenn; Michael Grimm |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Circulation Volume: 120 ISSN: 1524-4539 ISO Abbreviation: Circulation Publication Date: 2009 Sep |
Date Detail:
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Created Date: 2009-09-15 Completed Date: 2009-10-06 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: United States |
Other Details:
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Languages: eng Pagination: S198-205 Citation Subset: AIM; IM |
Affiliation:
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Department of Cardiothoracic Surgery, Medical University of Vienna, Austria. seyedhossein.aharinejad@meduniwien.ac.at |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged DNA Helicases / blood*, genetics Female Heart Transplantation / adverse effects*, mortality Humans Logistic Models Male Middle Aged Myocardium / metabolism Primary Graft Dysfunction / diagnosis* RNA, Messenger / analysis Survival Rate Tissue Donors* |
| Chemical | |
Reg. No./Substance:
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0/RNA, Messenger; EC 2.7.7.-/SMARCAL1 protein, human; EC 3.6.1.-/DNA Helicases |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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