Effect of thyroid hormone on cardiac function following orthotopic heart transplantation in piglets

Abstract

Studies in adult HT have demonstrated improved cardiac function in the recipient following administration of T3 to the donor. The purpose of this experiment was to assess the effects of T3 on the function of the immature donor heart following HT in a piglet model. A total of 32 piglets were divided into 16 donors and 16 recipients. Following creation of brain death, half of the donor piglets were randomized to receive three doses of T3 (0.2 μg/kg) along with hydrocortisone (1 mg/kg). The donor hearts were then transplanted into the recipient piglets on CPB. Duration of survival off CPB, inotrope score, and EF of heart following CPB were evaluated. There were no differences between the two groups in age, weight, pre-brain death EF, T3 levels, and CPB times. Post-CPB survival times were inversely related to the ischemic times in both groups (Pearson r=-0.80, P<.001), and this relationship was not influenced by T3. There was no difference in inotrope score, EF, or biochemical assessment between the two groups. Administration of T3 in combination with hydrocortisone to the brain-dead donor confers no beneficial effect on myocardial function or survival following HT in a piglet model.

Euthyroid sick syndrome in paediatric and adult patients requiring extracorporeal circulatory support and the role of thyroid hormone supplementation: a review

“…45 However, in a study of 2017 of HT in piglets, administration of T3 to the donor conferred no beneficial effect on myocardial performance or survival following HT. 44 Despite another study of animal HT that suggested the consideration by the authors of the T3 replacement therapy. 60 Therefore, further research needs to be conducted in humans in relation to HT.…”

“…Considering the limited number of organ donors, thyroid hormone therapy constitutes an element of donor stabilization at some transplant units in order to achieve optimal conditions for the available organs. 43,44…”

“…There was no variation in inotropic score, EF, biochemical analyses, myocardial performance or survival among the two arms. 44…”

“…Considering the limited number of organ donors, thyroid hormone therapy constitutes an element of donor stabilization at some transplant units in order to achieve optimal conditions for the available organs. 43,44 Data on 63,593 donors of hearts and lungs were retrospectively examined by Novitzky et al 45 T3/T4 treatment to the donor was related to either enhanced post-transplant graft and recipient survival or no variation in survival, indicating a remarkable favourable impact on heart and lung retrieval independent of other factors. Kumar et al assessed the impact of T3 on the performance of the immature donor heart in an animal model.…”

“…There was no variation in inotropic score, EF, biochemical analyses, myocardial performance or survival among the two arms. 44 In the paediatric population. Some studies in infants 30 reveal that T3 administration enhances cardiac function after the IR damage of CPB.…”