{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T14:32:43Z","timestamp":1787668363007,"version":"build-2736575974"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,12,20]],"date-time":"2025-12-20T00:00:00Z","timestamp":1766188800000},"content-version":"vor","delay-in-days":1654,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2021,6,10]],"date-time":"2021-06-10T00:00:00Z","timestamp":1623283200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Ratchadapisek Sompoch Endowment Fund (2019), Chulalongkorn University","award":["RA 62\/082"],"award-info":[{"award-number":["RA 62\/082"]}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This study aimed to examine (i) whether circulating growth differentiation factor-15 (GDF-15) is associated with acute cellular cardiac allograft rejection (ACR); (ii) a longitudinal trend of GDF-15 after heart transplantation; and (iii) the prognostic value of GDF-15 in predicting a composite outcome of severe primary graft dysfunction (PGD) and 30 day mortality post-transplant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Serum samples were collected before heart transplantation and at every endomyocardial biopsy (EMB) post-heart transplantation in de novo transplant patients. A total of 60 post-transplant serum samples were matched to the corresponding EMBs. Seven (12%) were considered International Society for Heart Lung Transplantation Grade 1R ACR, and one (2%) was identified as Grade 2R ACR. GDF-15 levels in patients with ACR were not different from those in the non-rejection group (6230 vs. 6125 pg\/mL, P = 0.27). GDF-15 concentration gradually decreased from 8757 pg\/mL pre-transplant to 5203 pg\/mL at 4 weeks post-transplant. The composite adverse outcome of PGD and 30 day mortality was significantly associated with increased post-operative GDF-15 (odds ratio: 40; 95% confidence interval: 2.01\u2013794.27; P = 0.005) and high inotrope score post-transplant (odds ratio: 18; 95% confidence interval: 1.22\u2013250.35; P = 0.01).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Circulating GDF-15 concentration was markedly elevated in patients with end-stage heart failure and decreased after heart transplantation. GDF-15 was significantly associated with post-transplant PGD and mortality. A lack of association between ACR and GDF-15 did not support routine use of GDF-15 as a biomarker to detect ACR. However, GDF-15 may be potentially useful to determine heart transplant recipients at high risk for adverse post-transplant outcomes. We suggest that GDF-15 levels in recipient serum can provide risk stratification for severe PGD including death during post-operative period. This novel biomarker may serve to inform and guide timely interventions against severe PGD and adverse outcomes during the first 4 weeks after transplantation. Further studies to support the utility of GDF-15 in heart transplantation are required.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.13471","type":"journal-article","created":{"date-parts":[[2021,6,10]],"date-time":"2021-06-10T19:16:04Z","timestamp":1623352564000},"page":"3279-3285","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Circulating Growth Differentiation Factor-15 as a Novel Biomarker in Heart Transplant"],"prefix":"10.1093","volume":"8","author":[{"given":"Nithi","family":"Tokavanich","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University , 1873 Rama IV Rd, Pathumwan, Bangkok, 10330 ,","place":["Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Supanee","family":"Sinphurmsukskul","sequence":"additional","affiliation":[{"name":"Excellent Center for Organ 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,","place":["Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aekarach","family":"Ariyachaipanich","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University , 1873 Rama IV Rd, Pathumwan, Bangkok, 10330 ,","place":["Thailand"]},{"name":"Excellent Center for Organ Transplantation, King Chulalongkorn Memorial Hospital, the Thai Red Cross Society , Bangkok ,","place":["Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pat","family":"Ongcharit","sequence":"additional","affiliation":[{"name":"Cardiac Center, King Chulalongkorn Memorial Hospital, the Thai Red Cross Society , Bangkok ,","place":["Thailand"]},{"name":"Division of Cardiothoracic Surgery, Department of Surgery, Faculty of Medicine, Chulalongkorn University , Bangkok ,","place":["Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarawut","family":"Siwamogsatham","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University , 1873 Rama IV Rd, Pathumwan, Bangkok, 10330 ,","place":["Thailand"]},{"name":"Chula Clinical Research Center, Faculty of Medicine, Chulalongkorn University , Bangkok ,","place":["Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Smonporn","family":"Boonyaratavej","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University , 1873 Rama IV Rd, Pathumwan, Bangkok, 10330 ,","place":["Thailand"]},{"name":"Cardiac Center, King Chulalongkorn Memorial Hospital, the Thai Red Cross Society , Bangkok 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