The role of thyroid hormone administration in potential organ Donors

Ali Salim, Pantelis Vassiliu, George C. Velmahos, Jack Sava, James A. Murray, Howard Belzberg, Juan A. Asensio, Demetrios Demetriades

Research output: Contribution to journalArticle

102 Citations (Scopus)

Abstract

Hypothesis: Levothyroxine sodium therapy should be used in brain-dead potential organ donors to reverse hemodynamic instability and to prevent cardiovascular collapse, leading to more available organs for transplantation. Design: Prospective, before and after clinical study. Setting: A surgical intensive care unit of an academic county hospital. Patients: During a 12-month period (September 1, 1999, through August 31, 2000), we evaluated 19 hemodynamically unstable patients with traumatic and nontraumatic intracranial lesions, who were candidates for organ donation following brain death declaration. Interventions: All patients were resuscitated aggressively for organ preservation by fluids, inotropic agents, and vasopressors. If, despite all measures, the patients remained hemodynamically unstable, a bolus of 1 ampule of 50% dextrose, 2 g of methylprednisolone sodium succinate, 20 U of insulin, and 20 μg of levothyroxine sodium was administered, followed by a continuous levothyroxine sodium infusion at 10 μg/h. Results: There was a significant reduction in the total vasopressor requirement after levothyroxine therapy (mean±SD, 11.1±0.9 μg/kg per minute vs 6.4±1.4 μg/kg per minute, P=.02). Ten patients (53%) had complete discontinuation of vasopressors. There were no failures to reach organ donation due to cardiopulmonary arrest. Conclusions: Levothyroxine therapy plays an important role in the management of hemodynamically unstable potential organ donors by decreasing vasopressor requirements and preventing cardiovascular collapse. This may result in an increase in the quantity and quality of organs available for transplantation.

Original languageEnglish
Pages (from-to)1377-1380
Number of pages4
JournalArchives of Surgery
Volume136
Issue number12
StatePublished - 2001
Externally publishedYes

Fingerprint

Thyroxine
Thyroid Hormones
Tissue Donors
Tissue and Organ Procurement
Brain Death
Organ Transplantation
Methylprednisolone Hemisuccinate
Play Therapy
Organ Preservation
County Hospitals
Vasoconstrictor Agents
Critical Care
Heart Arrest
Intensive Care Units
Hemodynamics
Insulin
Glucose
Therapeutics

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Salim, A., Vassiliu, P., Velmahos, G. C., Sava, J., Murray, J. A., Belzberg, H., ... Demetriades, D. (2001). The role of thyroid hormone administration in potential organ Donors. Archives of Surgery, 136(12), 1377-1380.

The role of thyroid hormone administration in potential organ Donors. / Salim, Ali; Vassiliu, Pantelis; Velmahos, George C.; Sava, Jack; Murray, James A.; Belzberg, Howard; Asensio, Juan A.; Demetriades, Demetrios.

In: Archives of Surgery, Vol. 136, No. 12, 2001, p. 1377-1380.

Research output: Contribution to journalArticle

Salim, A, Vassiliu, P, Velmahos, GC, Sava, J, Murray, JA, Belzberg, H, Asensio, JA & Demetriades, D 2001, 'The role of thyroid hormone administration in potential organ Donors', Archives of Surgery, vol. 136, no. 12, pp. 1377-1380.
Salim A, Vassiliu P, Velmahos GC, Sava J, Murray JA, Belzberg H et al. The role of thyroid hormone administration in potential organ Donors. Archives of Surgery. 2001;136(12):1377-1380.
Salim, Ali ; Vassiliu, Pantelis ; Velmahos, George C. ; Sava, Jack ; Murray, James A. ; Belzberg, Howard ; Asensio, Juan A. ; Demetriades, Demetrios. / The role of thyroid hormone administration in potential organ Donors. In: Archives of Surgery. 2001 ; Vol. 136, No. 12. pp. 1377-1380.
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abstract = "Hypothesis: Levothyroxine sodium therapy should be used in brain-dead potential organ donors to reverse hemodynamic instability and to prevent cardiovascular collapse, leading to more available organs for transplantation. Design: Prospective, before and after clinical study. Setting: A surgical intensive care unit of an academic county hospital. Patients: During a 12-month period (September 1, 1999, through August 31, 2000), we evaluated 19 hemodynamically unstable patients with traumatic and nontraumatic intracranial lesions, who were candidates for organ donation following brain death declaration. Interventions: All patients were resuscitated aggressively for organ preservation by fluids, inotropic agents, and vasopressors. If, despite all measures, the patients remained hemodynamically unstable, a bolus of 1 ampule of 50{\%} dextrose, 2 g of methylprednisolone sodium succinate, 20 U of insulin, and 20 μg of levothyroxine sodium was administered, followed by a continuous levothyroxine sodium infusion at 10 μg/h. Results: There was a significant reduction in the total vasopressor requirement after levothyroxine therapy (mean±SD, 11.1±0.9 μg/kg per minute vs 6.4±1.4 μg/kg per minute, P=.02). Ten patients (53{\%}) had complete discontinuation of vasopressors. There were no failures to reach organ donation due to cardiopulmonary arrest. Conclusions: Levothyroxine therapy plays an important role in the management of hemodynamically unstable potential organ donors by decreasing vasopressor requirements and preventing cardiovascular collapse. This may result in an increase in the quantity and quality of organs available for transplantation.",
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