DONOR THYROID-FUNCTION DOES NOT AFFECT OUTCOME IN ORTHOTOPIC LIVER-TRANSPLANTATION

Brainstem death is associated with endocrine and metabolic alterations that can result in donor hemodynamic instability. It has been suggest ed that these changes cam be reversed through hormonal manipulation of the donor. We measured thyroid hormone levels (free triiodothyronine [fT3], free tetraiodothyronine [fT4], reverse triiodothyronine) and th yroid-stimulating hormone (TSH) in 50 consecutive adult brain dead mul tiorgan donors. Recipient graft function was assessed using peak and d ay 5 aspartate aminotransferase, peak serum bilirubin, and minimum pro thrombin time during the first week after OLT. Free T3 was low in 32/5 0 donors and was associated with a low fT4 in 24 cases. TSH was normal in 35 donors and we found no correlation between TSH levels and fT3 o r fT4. Reverse triiodothyronine was normal or high in 96% of donors. P atient and graft survival were 96% for both the low and high fT3 group s. These data suggest that euthyroid sick syndrome is the most likely cause for the endocrine and metabolic alterations seen in brainstem-de ad donors. This does not appear to influence Liver recipient or graft survival.