Lauren B Cooper1,2, Carmelo A Milano3,4, Melissa Williams4, Wendy Swafford4, Donna Croezen5, Adrian B Van Bakel6, Joseph G Rogers2,3, Chetan B Patel2,3. 1. Inova Heart & Vascular Institute, Falls Church, VA, USA. 2. Department of Medicine, Duke University Medical Center, Durham, NC, USA. 3. Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA. 4. Department of Surgery, Duke University Medical Center, Durham, NC, USA. 5. Carolina Donor Services, Durham, NC, USA. 6. Department of Medicine, Medical University of South Carolina, Charleston, SC, USA.
Abstract
BACKGROUND: Acute hypothyroidism after brain death results in hemodynamic impairments that limit availability of donor hearts. Thyroid hormone infusions can halt that process and lead to increased utilization of donor organs, but prolonged use of thyroid replacement has not been well studied. METHODS: We developed a 15-question survey regarding policies, procedures, and reporting of thyroid hormone use by organ procurement organizations (OPOs). The survey was posted for 5 weeks on the Association of OPOs Portal. RESULTS: We received 29 responses, representing 24 OPOs. Seventy-two percent reported their OPOs use thyroid hormone for all potential donors and 90% have a protocol for thyroid hormone use. There is a large variation in the maximum dose of thyroid hormone used, and many OPOs have no weaning protocol. Most OPOs do not collect data on total thyroid hormone administered during procurement and would favor more detailed report of thyroid hormone use. CONCLUSIONS: Thyroid hormone use can have important implications for organ selection and cardiac function before and after transplantation. Protocols vary widely with respect to why and how to use and wean thyroid hormone. We believe there should be more detailed reporting of thyroid hormone use for future studies to ensure appropriate donor management.
BACKGROUND: Acute hypothyroidism after brain death results in hemodynamic impairments that limit availability of donor hearts. Thyroid hormone infusions can halt that process and lead to increased utilization of donor organs, but prolonged use of thyroid replacement has not been well studied. METHODS: We developed a 15-question survey regarding policies, procedures, and reporting of thyroid hormone use by organ procurement organizations (OPOs). The survey was posted for 5 weeks on the Association of OPOs Portal. RESULTS: We received 29 responses, representing 24 OPOs. Seventy-two percent reported their OPOs use thyroid hormone for all potential donors and 90% have a protocol for thyroid hormone use. There is a large variation in the maximum dose of thyroid hormone used, and many OPOs have no weaning protocol. Most OPOs do not collect data on total thyroid hormone administered during procurement and would favor more detailed report of thyroid hormone use. CONCLUSIONS:Thyroid hormone use can have important implications for organ selection and cardiac function before and after transplantation. Protocols vary widely with respect to why and how to use and wean thyroid hormone. We believe there should be more detailed reporting of thyroid hormone use for future studies to ensure appropriate donor management.
Authors: John D Rosendale; H Myron Kauffman; Maureen A McBride; Franki L Chabalewski; Jonathan G Zaroff; Edward R Garrity; Francis L Delmonico; Bruce R Rosengard Journal: Transplantation Date: 2003-02-27 Impact factor: 4.939
Authors: Jonathan G Zaroff; Bruce R Rosengard; William F Armstrong; Wayne D Babcock; Anthony D'Alessandro; G William Dec; Niloo M Edwards; Robert S Higgins; Valluvan Jeevanandum; Myron Kauffman; James K Kirklin; Stephen R Large; Daniel Marelli; Tammie S Peterson; W Steves Ring; Robert C Robbins; Stuart D Russell; David O Taylor; Adrian Van Bakel; John Wallwork; James B Young Journal: Circulation Date: 2002-08-13 Impact factor: 29.690
Authors: V Jeevanandam; B Todd; T Regillo; S Hellman; C Eldridge; J McClurken Journal: J Heart Lung Transplant Date: 1994 Jul-Aug Impact factor: 10.247
Authors: Jon Kobashigawa; Andreas Zuckermann; Peter Macdonald; Pascal Leprince; Fardad Esmailian; Minh Luu; Donna Mancini; Jignesh Patel; Rabia Razi; Hermann Reichenspurner; Stuart Russell; Javier Segovia; Nicolas Smedira; Josef Stehlik; Florian Wagner Journal: J Heart Lung Transplant Date: 2014-03-05 Impact factor: 10.247