Journal article
Levothyroxine therapy before brain death declaration increases the number of solid organ donations
The journal of trauma and acute care surgery, Vol.76(5), pp.1301-1305
05/01/2014
DOI: 10.1097/TA.0000000000000184
PMID: 24747464
Abstract
BACKGROUND: Protocols call for the start of hormonal therapy with levothyroxine after the declaration of brain death. As the hormonal perturbations occur during the process of brain death, the role of the early initiation of levothyroxine therapy (LT) to salvage organs is not well defined. The aim of this study was to evaluate the impact of early LT (before the declaration of brain death) on the number of solid organs procured per donor.
METHODS: We performed an 8-year retrospective analysis of all trauma patients who progressed to brain death. Patients who consented for organ donation, received LT, and donated solid organs were included. Patients were dichotomized into two groups: early LT group, patients who received LT before the declaration of brain death, and late LT group, those who received LT after brain death. The two groups were compared for differences in demographics, clinical characteristics, need for vasopressor, and number of solid organ donation.
RESULTS: A total of 100 solid organ donors were identified of which, 41% (n=77) donors who received LT therapy were included. LT before the declaration of brain death was initiated in 37 patients compared with 40 patients who had it started after the declaration of brain death. There was no difference in demographics between the two groups except that patients in the early LT group were more likely to be hypotensive on presentation (54% vs. 25%, p = 0.001). Early LT therapy was associated with an increase in solid organ procurement rate (odds ratio, 1.9; 95% confidence interval, 1.4-2.7; p = 0.01). Sixty-seven patients donated a total of 291 solid organs.
CONCLUSION: The early use of LT and aggressive blood product resuscitation was associated with a significantly higher number of solid organs donated per donor. Earlier use of LT before the declaration of brain death may be considered in potential organ donors. (J Trauma Acute Care Surg. 2014; 76: 1301-1305. Copyright (C) 2014 by Lippincott Williams & Wilkins)
Details
- Title: Subtitle
- Levothyroxine therapy before brain death declaration increases the number of solid organ donations
- Creators
- Bellal Joseph - University of ArizonaHassan Aziz - University of ArizonaViraj Pandit - University of ArizonaNarong Kulvatunyou - University of ArizonaMoutamn Sadoun - University of ArizonaAndrew Tang - University of ArizonaTerence O'Keeffe - University of ArizonaDonald J. Green - University of ArizonaRandall S. Friese - University of ArizonaPeter Rhee - University of Arizona
- Resource Type
- Journal article
- Publication Details
- The journal of trauma and acute care surgery, Vol.76(5), pp.1301-1305
- Publisher
- Lippincott Williams & Wilkins
- DOI
- 10.1097/TA.0000000000000184
- PMID
- 24747464
- ISSN
- 2163-0755
- eISSN
- 2163-0763
- Number of pages
- 5
- Language
- English
- Date published
- 05/01/2014
- Academic Unit
- Surgery
- Record Identifier
- 9984701543202771
Metrics
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