Levothyroxine Infusion Does Not Increase Heart Transplants Versus Saline Infusion

THURSDAY, Nov. 30, 2023 (HealthDay News) -- Intravenous levothyroxine infusion does not result in more hearts being transplanted than saline infusion among hemodynamically unstable brain-dead potential heart donors, according to a study published in the Nov. 30 issue of the New England Journal of Medicine.

Rajat Dhar, M.D., from the Washington University School of Medicine in St. Louis, and colleagues randomly assigned 838 hemodynamically unstable potential heart donors within 24 hours after declaration of death according to neurologic criteria to open-label infusion of intravenous levothyroxine or saline placebo (419 to each) in a trial involving 15 U.S. organ-procurement organizations.

Hearts were transplanted from 230 and 223 donors (54.9 and 53.2 percent) in the levothyroxine and saline groups, respectively (adjusted risk ratio, 1.01; 95 percent confidence interval, 0.97 to 1.07; P = 0.57). The researchers found that graft survival at 30 days occurred in 97.4 and 95.5 percent of hearts transplanted from donors assigned to receive levothyroxine and saline, respectively (difference, 1.9 percentage points; 95 percent confidence interval, −2.3 to 6.0; P < 0.001 for noninferiority). No substantial differences were seen between the groups in weaning from vasopressor therapy, ejection fraction on echocardiography, or organs transplanted per donor; there were more cases of severe hypertension and tachycardia in the levothyroxine versus the saline group.

"We found no significant benefit of intravenous levothyroxine treatment on improving donor heart utilization," the authors write.

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