Significance of Thyroid Dysfunction in Human Cardiac Allograft Procurement

Macoviak, John A.; McDougall, Ross; Bayer, Monika; Brown, Marguerite; Tazelaar, Henry D.; Stinson, Edward B.

doi:10.1097/00007890-198743060-00010

Cited by 2 publications

(3 citation statements)

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“…Recommendations for routine administration of thyroid hormone as part of donor management protocols have sparked considerable debate in the transplant community as its positive effects have not been reported in all studies (165,176,(179)(180)(181)(182)(183). The most convincing data pertain to cardiac function and heart transplantation, but conflicting reports exist even in this area (133,159,176,(183)(184)(185)(186). For example, in a prospective randomized, blinded, placebo-controlled study of 37 brain-dead patients, thyroid hormone treatment did not improve hemodynamic status or cardiac function (176).…”

Section: When Should Thyroid Replacement Therapy Be Considered?mentioning

confidence: 99%

Management of the Potential Organ Donor in the ICU

Kotloff

Blosser

Fulda

et al. 2015

Critical Care Medicine

272

150

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This document was developed through the collaborative efforts of the Society of Critical Care Medicine, the American College of Chest Physicians, and the Association of Organ Procurement Organizations. Under the auspices of these societies, a multidisciplinary, multi-institutional task force was convened, incorporating expertise in critical care medicine, organ donor management, and transplantation. Members of the task force were divided into 13 subcommittees, each focused on one of the following general or organ-specific areas: death determination using neurologic criteria, donation after circulatory death determination, authorization process, general contraindications to donation, hemodynamic management, endocrine dysfunction and hormone replacement therapy, pediatric donor management, cardiac donation, lung donation, liver donation, kidney donation, small bowel donation, and pancreas donation. Subcommittees were charged with generating a series of management-related questions related to their topic. For each question, subcommittees provided a summary of relevant literature and specific recommendations. The specific recommendations were approved by all members of the task force and then assembled into a complete document. Because the available literature was overwhelmingly comprised of observational studies and case series, representing low-quality evidence, a decision was made that the document would assume the form of a consensus statement rather than a formally graded guideline. The goal of this document is to provide critical care practitioners with essential information and practical recommendations related to management of the potential organ donor, based on the available literature and expert consensus.

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Section: When Should Thyroid Replacement Therapy Be Considered?mentioning

confidence: 99%

Management of the Potential Organ Donor in the ICU

Kotloff

Blosser

Fulda

et al. 2015

Critical Care Medicine

272

150

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“…In contrast to the above findings, a significant improvement of organ and metabolic function could not be found in several controlled studies with propagated substitution of triiodothyronine and cortisol [20,25,31,37,59,60,62,64,65,79]. It remains unclear whether hormone substitution is necessary or whether this is a pathophysiological state which does not require treatment.…”

Section: Treatment Of Endocrine Disordersmentioning

confidence: 85%

“…It remains unclear whether hormone substitution is necessary or whether this is a pathophysiological state which does not require treatment. Although there are indications that hormone substitution probably results in an improvement in the functions of the transplanted organs and a lowering of recipient mortality [51,56,80], there is no substantiated data that substitution of triiodothyronine and cortisol has a major effect in stabilizing the circulation in organ donors or on graft functions after transplantation [18,25,28,37]. As can be seen from our standardized phased schedule, in agreement with the American College of Cardiology [26], we recommend that intravenous administration of thyrotropin-releasing hormone (Relefact TRH ® ) at a dosage of 400 µg be tried in circulatory failure that is refractory to treatment.…”

Section: Treatment Of Endocrine Disordersmentioning

confidence: 99%

Intensive Care of the Multiorgan Donor

2000

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Disruption of central feedback regulatory loops leads to specific symptoms at the onset of brain death. Without consistent intensive care, these may cause the death of all organs within a few hours. In order to ensure optimal organ functioning after transplantation, specific minimum requirements must be met in respect of the way in which the multiorgan donor is treated.Standardized guidelines on therapeutic measures and monitoring of the brain-dead patients that are based on the current literature and our own experience will be presented in this paper.

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Significance of Thyroid Dysfunction in Human Cardiac Allograft Procurement

Cited by 2 publications

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Management of the Potential Organ Donor in the ICU

Management of the Potential Organ Donor in the ICU

Intensive Care of the Multiorgan Donor

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