Galectin-3 As An Early Marker Of Renal Dysfunction In Heart Transplant Patients: Short-term Results
Lorenzo Giovannico, Antonio D'Errico Ramirez, Domenico Parigino, Giuseppe Fischetti, Vincenzo Santeramo, Luca Savino, Tomaso Bottio, Aldo D. Milano.
Azienda Ospedaliera Universitaria Policlinico di Bari, Bari, Italy.
BACKGROUND: this study aims to understand the role of Galectin-3 (Gal-3) before and after heart transplant (HTx), the relation between its serum concentration and that found on biopsies (performed every week for the first month after the transplant) and to specify the possible value of this marker to predict the various post-HTx outcomes with particular focus on renal disfunction. A concomitant evaluation of ST2 is obtained. Gal-3 is a novel biomarker reflecting cardiac remodeling and fibrosis. Elevated serum levels of Gal-3 are associated with poor prognosis in patients with heart failure. However, the meaning of the change in levels of Gal-3 following HTx and its relation to possible outcomes remains unknown.
METHODS: Serum Gal-3 levels were measured in 14 patients at the time of admission for HTx, on the 7th and 30th day after transplant. Heart tissue, taken during routine endomyocardial biopsies (EMB), was analyzed to evaluate the correlation between the levels of Gal-3 found on tissue samples and the serum levels.
RESULTS: a significant correlation between pre-HTx Gal-3 levels and post-HTx eGFR values was found. In addition, there is a linear relation between post-HTx Gal-3 levels and post HTx-eGFR. No connection between Gal-3 serum level and HTx rejection was detected. The direct relation between the time between the diagnosis of heart failure and the date of transplantation and the levels of serum Gal-3 was also significant. Those results are comparable for ST2.
CONCLUSIONS: The correlation between post-HTx serum Gal-3 and eGFR levels make Gal-3 a predictive marker of kidney damage which could be useful in the stratification of risk for renal dysfunction after HTx. However, Gal-3 cannot be regarded as a rejection marker. Moreover, the longer the time from diagnosis to transplant, the higher the Gal-3 levels.
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