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

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 organs.