Using thyroid hormone in brain-dead donors to maximize the number of organs available for transplantation

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Clinical Transplantation

Volume 21 Issue 3 Page 405 - May/June 2007

Clinical Transplantation 21 (3), 405–409. doi:10.1111/j.1399-0012.2007.00659.x

Using thyroid hormone in brain-dead donors to maximize the number of organs available for transplantation

Ali SalimaaDivision of Trauma and Critical Care, Department of Surgery, University of Southern California Keck School of Medicine, aaDivision of Trauma and Critical Care, Department of Surgery, University of Southern California Keck School of Medicine, BrownaaDivision of Trauma and Critical Care, Department of Surgery, University of Southern California Keck School of Medicine, Kenji InabaaaDivision of Trauma and Critical Care, Department of Surgery, University of Southern California Keck School of Medicine, Bradley RothaaDivision of Trauma and Critical Care, Department of Surgery, University of Southern California Keck School of Medicine, Pantelis HadjizachariaaaDivision of Trauma and Critical Care, Department of Surgery, University of Southern California Keck School of Medicine, MascarenhasbbOne Legacy Organ Procurement Organization, and the Los Angeles County+University of Southern California Medical Center, Los Angeles, CA, USA, RheeaaDivision of Trauma and Critical Care, Department of Surgery, University of Southern California Keck School of Medicine and Demetrios DemetriadesaaDivision of Trauma and Critical Care, Department of Surgery, University of Southern California Keck School of Medicine

aDivision of Trauma and Critical Care, Department of Surgery, University of Southern California Keck School of Medicine and bOne Legacy Organ Procurement Organization, and the Los Angeles County+University of Southern California Medical Center, Los Angeles, CA, USA

Ali Salim MD, LAC+USC Medical Center, 1200 N. State Street, Dept. 9900, Los Angeles, CA 90033, USA.Tel.: +1 ; fax: +1 ;e-mail: asalim@...

Salim A, M, Brown C, Inaba K, Roth B, Hadjizacharia P, Mascarenhas A, Rhee P, Demetriades D. Using thyroid hormone in brain-dead donors to maximize the number of organs available for transplantation.Clin Transplant 2007: 21: 405–409. © Blackwell Munksgaard, 2007

Abstract

Abstract: The aggressive management of brain-dead (cadaveric) organ donors has been shown to increase organs available for transplantation. Some centers use hormone therapy with thyroid hormone (T4) in selected donors. The purpose of this study is to evaluate the effects of T4 on organs available for transplantation. A policy of aggressive donor management was adopted at our trauma center in 1998. T4 therapy is reserved for the hemodynamically unstable donors who require significant vasopressor support. The records of patients who successfully donated organs between January 2001 and December 2005 were reviewed. Organ donor demographics and whether T4 was used was examined for each donor. T4 was used in 96 of 123 donors (78%). Compared with donors who did not receive T4, those that did were similar in age (32 ± 14 vs. 38 ± 21, p = 0.148), had more organs donated (3.9 ± 1.7 vs. 3.2 ± 1.7, p = 0.048), and had no differences in brain-death related complications. Despite the severe hemodynamic instability in the T4 group, the number of organs harvested from this group was significantly more than in patients who did not receive T4. The use of T4 in this group may result in the increased salvage of transplantable organ