Increased Procurement of Thoracic Donor Organs After Thyroid Hormone Therapy

Semin Thorac Cardiovasc Surg. 2015 Summer;27(2):123-32. doi: 10.1053/j.semtcvs.2015.06.012. Epub 2015 Jul 2.


Hormonal therapy to the brain-dead organ donor can include thyroid hormone (triiodothyronine [T3] or levothyroxine [T4]), antidiuretic hormone, corticosteroids, or insulin. There has been a controversy on whether thyroid hormone enables more organs to be procured. Data on 63,593 donors of hearts and lungs (2000-2009) were retrospectively reviewed. Documentation on T3/T4 was available in all donors (study 1), and in 40,124 details of all 4 hormones were recorded (study 2). In this cohort, group A (23,022) received T3/T4 and group B (17,102) no T3/T4. Univariate analyses and multiple regressions were performed. Posttransplant graft and recipient survival at 1 and 12 months were compared. In study 1, 30,962 donors received T3/T4, with 36.59% providing a heart and 20.05% providing 1 or both lungs. Of the 32,631 donors who did not receive T3/T4, only 29.62% provided a heart and 14.61% provided lungs, an increase of 6.97% hearts and 5.44% lungs from T3/T4-treated donors (both P < 0.0001). In study 2, 34.99% of group A provided a heart and 20.99% provided lungs. In group B only 25.76% provided a heart and 15.09% provided lungs, an increase of 9.23% (hearts) and 5.90% (lungs), respectively, in group A (both P < 0.0001). The results of multiple regression analyses indicated a beneficial effect of T3/T4 on heart (P < 0.0001) and lung (P < 0.0001) procurement independent of other factors. T3/T4 therapy to the donor was associated with either improved posttransplant graft and recipient survival or no difference in survival. T3/T4 therapy results in more transplantable hearts and lungs, with no detriment to posttransplant graft or recipient survival.

Keywords: brain death; heart; lung; organ donation; thyroid hormone; transplantation.

Publication types

  • Comparative Study
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Brain Death*
  • Chi-Square Distribution
  • Donor Selection
  • Female
  • Graft Survival
  • Heart Transplantation* / adverse effects
  • Heart Transplantation* / mortality
  • Humans
  • Kaplan-Meier Estimate
  • Lung Transplantation* / adverse effects
  • Lung Transplantation* / mortality
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Odds Ratio
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Factors
  • Thyroxine / therapeutic use*
  • Time Factors
  • Tissue Donors / supply & distribution*
  • Tissue and Organ Procurement*
  • Treatment Outcome
  • Triiodothyronine / therapeutic use*
  • Young Adult


  • Triiodothyronine
  • Thyroxine