Background: Elevated troponin T at transplant evaluation has been reported to confer risk of cardiovascular mortality among renal transplants. We use troponin T along with assessment of cardiac function by ejection fraction (EF) on echocardiogram and 6 minute walk test distance (6MWT) and handgrip strength (HGS) as measures of physical performance and strength respectively in pre-transplant evaluation.

Research Question: We examined the strength and significance of associations between between pre-transplant troponin T and 6MWT, HGS, age, and resting EF among patients being evaluated for renal transplant.

Methods: A convenience sample of patients undergoing evaluation for renal transplant at a single center in the intermountain west between 2015 and 2017 was used. Of 575 patients screened for transplant during this time, 119 patients had undergone all tests of interest including troponin T, 6MWT, HGS, and resting EF. Patients without results available for all tests were excluded from analysis.

Results: Of the 119 patients, the mean age was 54.9 years, 52% were male, 83% were white, and 38% had diabetic nephropathy as a cause of ESRD.

There was no correlation between troponin T and age (R² = 0.000, p = 0.870) or troponin T and HGS (R² = 0.004, p = 0.473). There was a statistically significant but weak inverse correlation between troponin T and ejection fraction (R² = 0.127, p < 0.001) and troponin T and 6MWT (R²= 0.071, p = 0.003). The average troponin T for diabetic patients was 0.08 and for non-diabetic patients was 0.02 (p=0.03). Troponin T values were not used in isolation to determine candidature for transplantation and were not associated with waitlist mortality or post transplant mortality during the study period.

Conclusions: 1) Troponin T values track with diabetes, ejection fraction and 6MWT but not with age or HGS 2) The clinical significance of these correlations demands further study 3) The place of Troponin T when used in combination with measures of physical frailty for comprehensive evaluation of renal transplant candidates needs further study to determine utility.

CITATION INFORMATION: Gilligan S., Anand S., Morris D., Minder M., Srinivas T. Measures of Physical Frailty, Cardiac Function and Cardiac Biomarkers among Kidney Transplant Candidates Am J Transplant. 2017;17 (suppl 3).

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