title: Thyroid hormone use during cardiac transplant organ procurement.
abstract: Acute hypothyroidism after brain death results in hemodynamic impairments that limit availability of donor hearts. Thyroid hormone infusions can halt that process and lead to increased utilization of donor organs, but prolonged use of thyroid replacement has not been well studied.
  
  
  
  We developed a 15-question survey regarding policies, procedures, and reporting of thyroid hormone use by organ procurement organizations (OPOs). The survey was posted for 5 weeks on the Association of OPOs Portal.
  
  
  
  We received 29 responses, representing 24 OPOs. Seventy-two percent reported their OPOs use thyroid hormone for all potential donors and 90% have a protocol for thyroid hormone use. There is a large variation in the maximum dose of thyroid hormone used, and many OPOs have no weaning protocol. Most OPOs do not collect data on total thyroid hormone administered during procurement and would favor more detailed report of thyroid hormone use.
  
  
  
  Thyroid hormone use can have important implications for organ selection and cardiac function before and after transplantation. Protocols vary widely with respect to why and how to use and wean thyroid hormone. We believe there should be more detailed reporting of thyroid hormone use for future studies to ensure appropriate donor management.
authors.affiliation: Inova Heart & Vascular Institute, Falls Church, VA, USA.|Department of Medicine, Duke University Medical Center, Durham, NC, USA.
authors.forename: Lauren B
authors.identifier: 0000-0001-7980-333X
authors.initials: LB
authors.lastname: Cooper
authors.affiliation: Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA.|Department of Surgery, Duke University Medical Center, Durham, NC, USA.
authors.forename: Carmelo A
authors.initials: CA
authors.lastname: Milano
authors.affiliation: Department of Surgery, Duke University Medical Center, Durham, NC, USA.
authors.forename: Melissa
authors.initials: M
authors.lastname: Williams
authors.affiliation: Department of Surgery, Duke University Medical Center, Durham, NC, USA.
authors.forename: Wendy
authors.initials: W
authors.lastname: Swafford
authors.affiliation: Carolina Donor Services, Durham, NC, USA.
authors.forename: Donna
authors.initials: D
authors.lastname: Croezen
authors.affiliation: Department of Medicine, Medical University of South Carolina, Charleston, SC, USA.
authors.forename: Adrian B
authors.initials: AB
authors.lastname: Van Bakel
authors.affiliation: Department of Medicine, Duke University Medical Center, Durham, NC, USA.|Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA.
authors.forename: Joseph G
authors.initials: JG
authors.lastname: Rogers
authors.affiliation: Department of Medicine, Duke University Medical Center, Durham, NC, USA.|Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA.
authors.forename: Chetan B
authors.initials: CB
authors.lastname: Patel
mesh_terms: D001926:Brain Death; D002985:Clinical Protocols; D019538:Health Care Surveys; D006801:Humans; D007037:Hypothyroidism / Q000209:etiology / Q000517:prevention & control*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D013963:Thyroid Hormones / Q000627:therapeutic use*; D009927:Tissue and Organ Procurement / Q000379:methods*; D014481:United States
chemical_list: D013963:Thyroid Hormones
keywords: donor management; heart transplant; procurement; survey; thyroid hormone