• Eniko Holndonner-Kirst, Adam Nagy, Nikoletta Rahel Czobor, Levente Fazekas, Orsolya Dohan, Miklos D Kertai, Daniel Janos Lex, Balazs Sax, Istvan Hartyanszky, Bela Merkely, Janos Gal, and Andrea Szekely.
• Department of Anaesthesiology and Intensive Therapy, Semmelweis University, Budapest, Hungary; School of Doctoral Studies, Semmelweis University, Budapest, Hungary.
• J. Cardiothorac. Vasc. Anesth. 2019 Jun 1; 33 (6): 1629-1635.

ObjectiveThe effect of thyroid dysfunction on adverse outcomes has been studied in many different patient populations. The objective of this study was to investigate the effect of thyroid hormone supplementation of donors and recipients on postoperative outcomes after orthotopic heart transplantation.DesignRetrospective.SettingSingle center, university hospital.ParticipantsTwo-hundred and sixty-six consecutive patients undergoing heart transplantation.InterventionsNo interventions.Measurements And Main ResultsDemographic, hemodynamic, and clinical characteristics; donor and recipient United Network for Organ Sharing scores; and information on thyroid hormone support of donors and recipients were recorded. During the median follow-up of 4.59 years (interquartile range 4.26-4.92 y), 70 patients (26.3%) died. After adjustments were made for the United Network for Organ Sharing score, recipients who were treated preoperatively with l-thyroxine had a lower risk for all-cause mortality (adjusted hazard ratio [HR] 0.24, 95% confidence interval [CI] 0.06-0.98; p = 0.047) compared with recipients who were not treated with l-thyroxine. In addition, l-thyroxine treatment of donors was associated with a better recipient survival (HR 0.31, 95% CI 0.11-0.87; p = 0.025).ConclusionsPretransplantation thyroid hormone supplementation of donors and recipients was associated with improved long-term survival after heart transplantation.Copyright © 2018 Elsevier Inc. All rights reserved.

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