Suppression of tumorigenicity‐2 (ST2) is a promising biomarker in heart transplantation

Abstract

Background To evaluate the association between donors’ and recipients’ serum levels of soluble ST2 (sST2) and recipients’ outcome after heart transplantation (HT). Methods Blood samples were collected in 50 heart donors before organ procurement and in 50 recipients before HT (D0), a week after HT (D7) and at every first year's endomyocardial biopsy (EMB); sST2 levels were evaluated by ELISA. Results Donors who sustained a cardiac arrest, had significantly higher sST2 levels. Recipients on national high emergency waiting list had significantly higher preoperative sST2 levels compared to recipients who did not. Recipients with postoperative sepsis or continuous renal replacement therapy had significantly higher sST2 levels at D7. Recipients who needed a postoperative ECMO for allograft dysfunction had significantly higher sST2 levels in their corresponding donors. Recipients who died during the hospitalization after the transplantation had significantly higher sST2 levels at D7 compared to recipients who did not. No difference was observed in sST2 levels in recipients who had mild allograft rejection and recipient who did not. Conclusions Higher sST2 levels in donors are associated to allograft dysfunction requiring ECMO in recipients; higher postoperative sST2 levels in recipients are associated with in‐hospital mortality.

Ten-Year Experience with Endomyocardial Biopsy after Orthotopic Heart Transplantation: Comparison between Trans-Jugular and Trans-Femoral Approach

“…Several biomarkers have been proposed to detect and monitor allograft rejection after HT. The ST2/IL-33 pathway has been shown to be involved in the context of acute rejection after HT in both adults and pediatric heart recipients [36,37]. Serum sST2 levels significantly rise in the context of acute rejection showing a linear association with severity of acute rejection and decline after successful rejection therapy [38,39].…”

The ST2/IL-33 Pathway in Adult and Paediatric Heart Disease and Transplantation

“…A recent study explored the role of sST2 serum levels in heart donors and allograft function following heart transplantation for the first time [ 75 ]. The authors demonstrated that brain-dead organ donors have considerably high levels of sST2.…”

“…The higher levels were observed in older donors and in donors with reduced LVEF, or have need for inotropic support and after-cardiac-arrest resuscitation. Additionally, elevated sST2 serum levels in donors were associated with allograft dysfunction in heart recipients [ 75 ]. Assessment of biomarkers is of paramount importance in potential heart donors as it may provide important predictive information and allows for risk stratification, especially in marginal donors, who are increasingly accepted due to the for scarcity of heart donors [ 76 ].…”