School of Medicine

Long-standing hormone treatment for donated hearts found to be ineffective

Washington University physician Raj Dhar, MD, (front) and Gary Marklin, MD, the chief medical officer at Mid-America Transplant in St. Louis, care for a deceased organ donor. Dhar and Marklin led a study that showed that the long-standing practice of treating deceased organ donors with thyroid hormone does not help preserve heart function, may cause harm and should be discontinued. (Photo: Matt Miller/School of Medicine)

Doctors managing deceased organ donors routinely treat the donors’ bodies with thyroid hormones in a bid to preserve heart function and increase the quantity and quality of hearts and other organs available for transplantation. However, according to a recent clinical trial led by researchers at Washington University School of Medicine in St. Louis and Mid-America Transplant in St. Louis, routine thyroid hormone intervention is not effective at achieving these goals, and may even cause harm.

The study is published Nov. 30 in The New England Journal of Medicine.

“There have been very few studies of what really works in terms of preserving organ function for donation — and with a shortage of donor organs for transplantation, it’s critical to do what we can to preserve organs and save lives with them,” said Raj Dhar, MD, a professor of neurology at Washington University and an attending physician in the Neurology/Neurosurgery Intensive Care Unit at Barnes-Jewish Hospital. Dhar is the corresponding author on the paper and led the clinical trial with Gary Marklin, MD, the chief medical and research officer at Mid-America Transplant, the organ-procurement organization for the St. Louis region.

“We decided to investigate whether intravenous thyroid hormone would result in more hearts transplanted,” Dhar said. “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.”

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