• Stefan Andrei, Elie Kantor, Maksud Asssadi, Anne Boutten, Quentin Pellenc, Gilles Jebrak, Mathieu Godement, Samia Abbas, Enora Atchade, Alexy Tran-Dinh, Tiphaine Robert-Mercier, Liana Valeanu, Dan Longrois, Philippe Montravers, and Pascal Augustin.
• Département d'Anesthésie Réanimation, CHU Bichat-Claude Bernard, Université Paris-Diderot, Paris, France. Electronic address: stefan.m.andrei@gmail.com.
• J. Cardiothorac. Vasc. Anesth. 2022 Aug 1; 36 (8 Pt A): 2328-2334.

ObjectivesPostoperative cardiac troponin I concentration is predictive of worsened outcomes in cardiac surgery. Lung transplantation (LT) surgery shares common features with cardiac surgery, but postoperative troponin has yet to be investigated. The authors aimed to evaluate the association between early postoperative troponin concentration and the 1-year mortality after transplantation.DesignA retrospective, observational, single-center study.SettingAt a tertiary care, university hospital.ParticipantsPatients who underwent lung transplantation from January 2011 to December 2017 INTERVENTIONS: For each patient, preoperative, intraoperative, and postoperative data were collected, as well as the troponin I measurement at the moment of postoperative intensive care unit admission.Measurements And Main ResultsTwo hundred twenty LT procedures were analyzed. Troponin I was elevated in all LT patients, with a median of 3.82 ng/mL-1 (2-6.42) ng/mL-1 significantly higher in non-survivors than in survivors with 5.39 (2.88-7.44) v 3.50 ng/mL (1.74-5.76), p = 0.005. In the multivariate analysis, the authors found that only the Simplified Acute Physiology Score II score (hazard ratio [HR] 1.03; 95% confidence interval [CI] [1.001; 1.05]; p = 0.007) and the need to maintain extracorporeal life support at the end of surgery (HR 2.54; 95% CI [1.36; 4.73]; p = 0.003) were independently associated with the 1-year mortality. The multiple linear regression model found that troponin levels were associated with the need for extracorporeal life support (ECLS) (p = 0.014), the amount of transfused packed red blood cells (p = 0.008), and bilateral LT (p < 0.001).ConclusionEarly postoperative troponin serum levels were not independently associated with 1-year mortality. Early postoperative troponin I levels were correlated to bilateral LT, the need for ECLS, and intraoperative blood transfusion.Copyright © 2021 Elsevier Inc. All rights reserved.

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