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Related Experiment Videos

Donor thyroid function does not affect outcome in orthotopic liver transplantation

K Karayalçin1, J P Umaña, J D Harrison

  • 1Liver and Hepatobiliary Unit, Queen Elizabeth Hospital, Edgbaston, Birmingham, United Kingdom.

Transplantation
|March 15, 1994
PubMed
Summary

Brainstem death causes thyroid hormone changes, likely euthyroid sick syndrome. These alterations in organ donors do not impact liver transplant recipient or graft survival rates.

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Area of Science:

  • Endocrinology
  • Transplantation Immunology
  • Critical Care Medicine

Background:

  • Brainstem death can lead to hemodynamic instability due to endocrine and metabolic changes.
  • Hormonal manipulation of organ donors is a potential strategy to reverse these alterations.
  • Thyroid hormone dysfunction is frequently observed in critically ill patients.

Purpose of the Study:

  • To investigate thyroid hormone levels in brainstem-dead organ donors.
  • To determine the correlation between thyroid hormone levels and donor characteristics.
  • To assess the impact of donor thyroid hormone levels on liver transplant recipient and graft outcomes.

Main Methods:

  • Measurement of serum free triiodothyronine (fT3), free tetraiodothyronine (fT4), reverse triiodothyronine, and thyroid-stimulating hormone (TSH) in 50 brainstem-dead donors.

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  • Assessment of recipient liver graft function using liver enzymes (AST, bilirubin) and prothrombin time post-orthotopic liver transplantation (OLT).

    • Main Results:

    • Low fT3 levels were observed in 32/50 donors, often with low fT4.
    • TSH levels were mostly normal, with no significant correlation to fT3 or fT4.
    • Reverse triiodothyronine was normal or elevated in 96% of donors.
    • Patient and graft survival rates were high (96%) regardless of donor fT3 levels.

    Conclusions:

    • Euthyroid sick syndrome is the probable cause of thyroid dysfunction in brainstem-dead donors.
    • Donor thyroid hormone alterations do not adversely affect liver transplant outcomes.
    • Hormonal manipulation may not be necessary to improve graft survival in liver transplantation.