A study coordinated by specialists from Bellvitge University Hospital and the Bellvitge Biomedical Research Institute (IDIBELL) has discovered a biological feature in heart donors that makes the transplant result worse.
The study has found that if the donor has low levels of an enzyme called caspase 3 there are more possibilities of dysfunction or rejection of the graft. Caspase 3 is an enzyme responsible for executing the programmed death of cells. According to this study, its action preconditions the donor’s heart cells in a way that helps to make this organ better tolerated once transplanted.
The researchers are confident that this discovery – on which further studies are needed – will help improve organ selection and transplant results.
Heart transplantation is the reference treatment for people with advanced heart failure. Although survival after one year is close to 90%, graft dysfunction is the main cause of problems in this initial phase and is fatal between 19 and 28% of cases. The generalization of the use of external circulatory support has helped to better address these situations, but it remains one of the main challenges in improving transplant results.
Transplanted patients from 7 hospitals
The work, published in the International Journal of Molecular Sciences, has been led, among others, by Dr. Lorena Herrador (first signer), Dr. Gabriel Moreno González and Dr. José González Costello. This is one of the largest studies to date on the relationship between serum biomarkers of cell death and the clinical results of heart transplantation.
The research retrospectively involved a total of 78 patients: 39 heart donors in brain death and the 39 people who received these organs. The donors were all people admitted to the Intensive Care Unit of the Bellvitge University Hospital between August 2013 and July 2018. From the blood samples of these people, inflammatory cytokines, proteins related to cell death, mitochondrial DNA and genomic DNA were mainly analyzed.
Regarding the recipients, whose clinical evolution data were mainly analysed, they were people intervened at the Bellvitge University Hospital, the Hospital de la Santa Creu i Sant Pau, the Hospital Clínic, the Miguel Servet University Hospital (Zaragoza), the La Fe University and Polytechnic Hospital (Valencia), the Gregorio Maraónón General University Hospital (Madrid), and the Virgen de la Arrixaca University Hospital (Murcia).
According to Dr. Gabriel Moreno González, director of the Transplant Program at Bellvitge University Hospital, researcher at IDIBELL, and one of the main authors of the study, “these results reveal the critical influence that the donor has on the results of transplantation and the unexplored potential of the donor’s serum biomarkers in transplantation. We are sure that this path we have opened will be increasingly important to evaluate the prognosis and to take clinical decisions”.
About IDIBELL
The Bellvitge Biomedical Research Institute (IDIBELL) is a research center established in 2004 specialized in cancer, neuroscience, translational medicine, and regenerative medicine. It counts on a team of more than 1.500 professionals who, from 73 research groups, publish more than 1.400 scientific articles per year. IDIBELL is participated by the Bellvitge University Hospital and the Viladecans Hospital of the Catalan Institute of Health, the Catalan Institute of Oncology, the University of Barcelona, and the City Council of L’Hospitalet de Llobregat.
IDIBELL is a member of the Campus of International Excellence of the University of Barcelona HUBc and is part of the CERCA institution of the Generalitat de Catalunya. In 2009 it became one of the first five Spanish research centers accredited as a health research institute by the Carlos III Health Institute. In addition, it is part of the “HR Excellence in Research” program of the European Union and is a member of EATRIS and REGIC. Since 2018, IDIBELL has been an Accredited Center of the AECC Scientific Foundation (FCAECC).
About Bellvitge University Hospital (HUB)
Bellvitge Hospital is a public, university, research and innovative hospital. With more than 5,200 expert and committed professionals, it is the proximity hospital of the citizens of L’Hospitalet and El Prat del Llobregat and a reference center of maximum complexity for 2 million people, all the southern axis of Catalonia. It is the Catalan health center that performs the most complex surgery, especially oncological surgery, and is part of the Bellvitge Health Campus, recognized by the Organization of European Cancer Institutes (OECI) as a Comprehensive Cancer Center for its excellence in cancer care, research and teaching. It integrates in the projects the orientation to the improvement of the patient experience and the networking with primary care and hospital centers in the environment. Oriented to personalized medicine, it has the best genetic diagnosis and imaging tools for cancer and rare diseases, which are complemented by the High Precision Diagnostic Center, which has the first PET / Magnetic Resonance of the healthcare network in Spain. It records approximately 26,000 major surgery interventions annually; 39,000 high; 400,000 outpatient visits and about 100,000 diagnostic tests.