Related Experiment Video
Updated: Dec 22, 2025
Trans-vivo Delayed Type Hypersensitivity Assay for Antigen Specific Regulation
Published on: May 2, 2013
Donor thyroid hormone therapy is associated with an increased risk of graft dysfunction after heart transplantation
Yael Peled1,2, Jacob Lavee1,2, Yigal Kassif1,2
1Heart Transplantation Unit, Leviev Cardiothoracic and Vascular Center, Sheba Medical Center, Tel Hashomer, Israel.
Insights
Donor thyroid hormone therapy significantly increases the risk of primary graft dysfunction (PGD) after heart transplantation (HT). A "withdrawal effect" may cause this, suggesting recipient thyroid hormone therapy could be protective.
Area of Science:
- Cardiology
- Endocrinology
- Transplantation Medicine
Background:
- Thyroid hormone therapy has potential impacts on heart transplantation (HT) at donor, operative, and recipient levels.
- Understanding these impacts is crucial for improving HT outcomes.
Purpose of the Study:
- To investigate the effect of donor thyroid hormone therapy on primary graft dysfunction (PGD) in heart transplant recipients.
Main Methods:
- Retrospective cohort study of 209 HT recipients (1997-2018).
- Donors were categorized based on T4 administration (DT4 group vs. NoDT4 group).
- PGD incidence and severity were assessed using the International Society for Heart and Lung consensus statement criteria.
Main Results:
- Higher incidence (58% vs. 35%) and severity (42% vs. 25%) of PGD in recipients whose donors received T4.
- Donor T4 therapy was independently associated with a 3.5-fold increased risk of PGD (OR = 3.44).
- Results were consistent after propensity score analysis.
Conclusions:
- Donor thyroid hormone therapy is independently linked to increased PGD risk.
- A "withdrawal effect" is hypothesized as the mechanism.
- Recipient thyroid hormone administration at reperfusion may counteract PGD; prospective studies are warranted.
Objective:
Heart transplantation (HT) is uniquely associated with the potential impact of thyroid hormone therapy at three intersecting levels-donor, operation, and recipient. We aimed to study the effect of thyroid hormone therapy of the donor on primary graft dysfunction (PGD).
Methods:
A retrospective cohort study was conducted on 209 HT recipients assessed from 1997 to 2018; for 33 of the recipients, the donors had received T4 (DT4 group), and for 176, the donors had not (NoDT4 group). The primary endpoint was PGD defined according to the International Society for Heart and Lung consensus statement.
Results:
Both the incidence (58% vs 35%, P = .022) and the severity of PGD (42% vs 25% moderate/severe, P = .007) were significantly higher in the DT4 recipients. Multivariable analysis showed donor T4 therapy to be independently associated with a ~3.5-fold increased risk for PGD (OR = 3.44, 95% CI 1.26-9.86). These results remained consistent after propensity score analysis.
Conclusions:
Donor thyroid hormone therapy is independently associated with an increased risk of PGD. Hypothesizing a "withdrawal effect" as the cause, we suggest that administration of thyroid hormone to the recipient at time of reperfusion could counter this negative effect. Prospective studies are needed to validate this hypothesis-generating study.
More Related Videos
Related Concept Videos
01:28Kidney Transplant I: Introduction
01:24Tissue Transplantation
The Biology of Tissue Transplantation
The biology of tissue transplantation hinges on the Major Histocompatibility Complex (MHC) molecules. These molecules...
01:26Kidney Transplant II: Surgical Procedure
01:22Bone Marrow Sampling and Transplants
The transplant begins with high doses of chemotherapy and radiation treatment, which aim to destroy...
01:18Functions of Thyroid Hormones
TH is indispensable for the normal development and maturation of the skeletal, muscular, and nervous systems during fetal and childhood growth. It facilitates bone mineral turnover and regulates protein synthesis in developing tissues, contributing significantly to overall growth and...