Does the use of double hormone replacement therapy for trauma patient organ donors improve organ recovery for transplant  

作　　者：Eden M Gallegos Tanner Reed Paige Deville Blake Platt Claudia Leonardi Lillian Bellfi Jessica Dufrene Saad Chaudhary John Hunt Lance Stuke Patrick Greiffenstein Jonathan Schoen Alan Marr Anil Paramesh Alison A Smith 

机构地区：[1]Department of Physiology,Louisiana State University Health Sciences Center New Orleans,New Orleans,LA 70124,United States [2]Department of Medicine,Louisiana State University Health Sciences Center New Orleans,New Orleans,LA 70112,United States [3]Department of Surgery,Louisiana State University Health Sciences Center New Orleans,New Orleans,LA 70112,United States [4]Department of Trauma Surgery,Tacoma General Hospital,Tacoma 98405,United States [5]Department of Public Health,Louisiana State University Health Sciences Center New Orleans,New Orleans,LA 70112,United States [6]Department of Donation Services,Louisiana Organ Procurement Agency,Covington,LA 70433,United States [7]Department of Surgery,Tulane Transplant Institute,Tulane University School of Medicine,New Orleans,LA 70112,United States

出　　处：《World Journal of Transplantation》2024年第2期119-125,共7页世界移植杂志

摘　　要：BACKGROUND With an ongoing demand for transplantable organs,optimization of donor management protocols,specifically in trauma populations,is important for obta-ining a high yield of viable organs per patient.Endocrine management of brain-dead potential organ donors(BPODs)is controversial,leading to heterogeneous clinical management approaches.Previous studies have shown that when levo-thyroxine was combined with other treatments,including steroids,vasopressin,and insulin,BPODs had better organ recovery and survival outcomes were increased for transplant recipients.AIM To determine if levothyroxine use in combination with steroids in BPODs increased the number of organs donated in trauma patients.METHODS A retrospective review of adult BPODs from a single level 1 trauma center over ten years was performed.Exclusion criteria included patients who were not solid organ donors,patients who were not declared brain dead(donation after circulatory death),and patients who did not receive steroids in their hospital course.Levothyroxine and steroid administration,the number of organs donated,the types of organs donated,and demographic information were recorded.Univariate analyses were performed with P<0.05 considered to be statistically significant.RESULTS A total of 88 patients met inclusion criteria,69(78%)of whom received levothyroxine and steroids(ST/LT group)vs 19(22%)receiving steroids without levothyroxine(ST group).No differences were observed between the groups for gender,race,pertinent injury factors,age,or other hormone therapies used(P>0.05).In the ST/LT group,68.1%(n=47)donated a high yield(3-5)of organ types per donor compared to 42.1%(n=8)in the ST group(P=0.038).There was no difference in the total number of organ types donated between the groups(P=0.068).CONCLUSION This study suggests that combining levothyroxine and steroid administration increases high-yield organ donation per donor in BPODs in the trauma patient population.Limitations to this study include the retrospective design and the relatively smal

关 键 词：Organ donation TRAUMA Brain death LEVOTHYROXINE Hormone replacement therapy STEROIDS Organ donor RETROSPECTIVE 

分 类 号：R193.3[医药卫生—卫生事业管理]