‘We should halt this practice’: Common hormone treatment for donated hearts may be harmful
The bodies of organ donors are regularly treated with thyroid hormones to preserve heart function and ensure any transplant procedures are a success. However, a new study published in The New England Journal of Medicine suggests those hormones are ineffective—and may even be increasing the risk of certain adverse outcomes.[1]
“We decided to investigate whether intravenous thyroid hormone would result in more hearts transplanted,” corresponding author Raj Dhar, MD, a neurologist with Washington University School of Medicine in St. Louis and Barnes-Jewish Hospital, said in a statement. “This practice has been adopted by multiple organ-procurement organizations and is used on thousands of organ donors each year, without ever having been rigorously studied. It turns out that it doesn’t have any benefit and may cause some harm. Our findings tell us we should halt this practice.”
Dhar et al. worked with 15 different organ-procurement groups to examine data from 838 organ donors who had been declared dead according to specific neurological parameters. Exactly half of those donors received intravenous levothyroxine—a common treatment for hypothyroidism—within the first 24 hours of death being officially declared. The other donors were treated with a saline placebo.
Overall, 54.9% of hearts from the levothyroxine group and 53.2% of hearts from the placebo group were transplanted. Graft survival 30 days after transplantation was seen in 97.4% of hearts from the levothyroxine group and 95.5% of hearts from the placebo group. While the levothyroxine group was technically linked to a higher success rate in both of these instances, the differences were not statistically significant.
In addition, the team found evidence that levothyroxine was associated with an increased risk of hypertension and abnormally fast heart rates. This suggests the routine hormone treatment may actually cause the heart to be overstimulated, causing harm at a time when it was believed to be providing a clear benefit.
“We found good evidence that this intervention we’ve been using for 40 years doesn’t work,” Dhar said. “It’s vital that we explore questions like this to ensure we are doing all we can for patients who need organs—and to ensure that they receive the most benefit possible from the generous people who choose to donate organs.”
Dhar added that some organ-procurement organizations have already stopped using levothyroxine therapy due to the results of this analysis.
Click here to read the full analysis in The New England Journal of Medicine.
Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.