Thyroid hormone use during cardiac transplant organ procurement

Area of Science:

• Organ transplantation
• Endocrinology
• Critical care medicine

Background:

• Brain death can cause acute hypothyroidism, leading to hemodynamic instability that compromises donor heart availability.
• Thyroid hormone infusions can mitigate these effects, potentially increasing donor organ utilization.
• However, the long-term use and management of thyroid hormone replacement in donors remain understudied.

Purpose of the Study:

• To investigate the current policies and practices of organ procurement organizations (OPOs) regarding thyroid hormone use in potential organ donors.
• To identify variations in protocols for administering and weaning thyroid hormone.
• To highlight the need for standardized reporting of thyroid hormone administration in donor management.

Main Methods:

• A 15-question survey was developed to assess OPO policies on thyroid hormone use.
• The survey was distributed online via the Association of OPOs Portal for five weeks.
• Data were collected from responding OPOs to analyze current practices.

Main Results:

• Twenty-nine responses were received from 24 OPOs, with 72% using thyroid hormone for all potential donors.
• Ninety percent of OPOs have a protocol for thyroid hormone use, but significant variation exists in maximum dosage and weaning procedures.
• Most OPOs do not collect comprehensive data on total thyroid hormone administered and desire more detailed reporting.

Conclusions:

• Thyroid hormone administration significantly impacts organ selection and cardiac function in donors and recipients.
• Current protocols for thyroid hormone use and weaning in organ donation are inconsistent across OPOs.
• Standardized and detailed reporting of thyroid hormone use is crucial for future research and optimal donor management to improve transplant outcomes.