• Andre F Gosling, Mary C Wright, Anne Cherry, Carmelo A Milano, Chetan B Patel, Jacob N Schroder, Adam DeVore, Sharon McCartney, Daryl Kerr, Benjamin Bryner, Mihai Podgoreanu, and Alina Nicoara.
• Department of Anesthesiology, Duke University School of Medicine, Durham, NC. Electronic address: afichegosling@uabmc.edu.
• J. Cardiothorac. Vasc. Anesth. 2023 Nov 1; 37 (11): 223622432236-2243.

ObjectivesTo investigate whether recipient administration of thyroid hormone (liothyronine [T3]) is associated with reduced rates of primary graft dysfunction (PGD) after orthotopic heart transplantation.DesignRetrospective cohort study.SettingSingle-center, university hospital.ParticipantsAdult patients undergoing orthotopic heart transplantation.InterventionsA total of 609 adult heart transplant recipients were divided into 2 cohorts: patients who did not receive T3 (no T3 group, from 2009 to 2014), and patients who received T3 (T3 group, from 2015 to 2019). Propensity-adjusted logistic regression was performed to assess the association between T3 supplementation and PGD.Measurements And Main ResultsAfter applying exclusion criteria and propensity-score analysis, the final cohort included 461 patients. The incidence of PGD was not significantly different between the groups (33.9% no T3 group v 40.8% T3 group; p = 0.32). Mortality at 30 days (3% no T3 group v 2% T3 group; p = 0.53) and 1 year (10% no T3 group v 12% T3 group; p = 0.26) were also not significantly different. When assessing the severity of PGD, there were no differences in the groups' rates of moderate PGD (not requiring mechanical circulatory support other than an intra-aortic balloon pump) or severe PGD (requiring mechanical circulatory support other than an intra-aortic balloon pump). However, segmented time regression analysis revealed that patients in the T3 group were less likely to develop severe PGD.ConclusionsThese findings indicated that recipient single-dose thyroid hormone administration may not protect against the development of PGD, but may attenuate the severity of PGD.Copyright © 2023 Elsevier Inc. All rights reserved.

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