title: Using thyroid hormone in brain-dead donors to maximize the number of organs available for transplantation.
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 (T(4)) in selected donors. The purpose of this study is to evaluate the effects of T(4) on organs available for transplantation. A policy of aggressive donor management was adopted at our trauma center in 1998. T(4) 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 T(4) was used was examined for each donor. T(4) was used in 96 of 123 donors (78%). Compared with donors who did not receive T(4), 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 T(4) group, the number of organs harvested from this group was significantly more than in patients who did not receive T(4). The use of T(4) in this group may result in the increased salvage of transplantable organs.
authors.affiliation: Division of Trauma and Critical Care, Department of Surgery, University of Southern California Keck School of Medicine, Los Angeles, CA 90033, USA. asalim@surgery.usc.edu
authors.forename: Ali
authors.initials: A
authors.lastname: Salim
authors.forename: Matthew
authors.initials: M
authors.lastname: Martin
authors.forename: Carlos
authors.initials: C
authors.lastname: Brown
authors.forename: Kenji
authors.initials: K
authors.lastname: Inaba
authors.forename: Bradley
authors.initials: B
authors.lastname: Roth
authors.forename: Pantelis
authors.initials: P
authors.lastname: Hadjizacharia
authors.forename: Angela
authors.initials: A
authors.lastname: Mascarenhas
authors.forename: Peter
authors.initials: P
authors.lastname: Rhee
authors.forename: Demetrios
authors.initials: D
authors.lastname: Demetriades
mesh_terms: D000328:Adult; D001926:Brain Death; D002985:Clinical Protocols; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013974:Thyroxine / Q000627:therapeutic use*; D014019:Tissue Donors; D020858:Tissue and Organ Harvesting; D019737:Transplants / Q000600:supply & distribution*
chemical_list: D013974:Thyroxine