The Perioperative Period of Heart Transplantation Is Affected by Thyroid Hormone Status
Authors' conclusion
We conclude that TH status plays an important role in HTx patients, and monitoring of TH status in the perioperative period may contribute to improved treatment outcomes.
Study context
- Population
- Patients undergoing orthotopic HTx for end-stage HF, 2013–2020, Heart and Vascular Center of Semmelweis University, Hungary
- Participants
- 283 patients
- Outcome
- Associations between altered thyroid hormone status and adverse outcomes after HTx
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
- Serum TSH lower after HTx than preoperatively
- p = 0.009
- Serum free triiodothyronine (fT3) lower after HTx than preoperatively
- p < 0.001
- Serum free thyroxine (fT4) lower after HTx than preoperatively
- p < 0.001
- Levothyroxine (LT4) given to donors associated with better survival after 30 days
- p = 0.049
- LT4 replacement given to recipients after HTx associated with better survival after 30 days
- p = 0.018
- LT4 replacement given to recipients associated with better survival after 1 year
- p = 0.002
- LT4 replacement given to recipients associated with better survival after 2 years
- p = 0.001
Observational data: associations, not effects.
Further findings
Cardiac Dio3 mRNA by mechanical circulatory support vs no mechanical circulatory support (MCS)
- Dio3 mRNA increased with preoperative extracorporeal membrane oxygenation (ECMO) vs no MCS
- P = 0.026
- Dio3 mRNA increased with preoperative left ventricular assist device (LVAD) vs no MCS
- P = 0.008
- Dio3 mRNA increased with preoperative biventricular assist device (BiVAD) vs no MCS
- P = 0.013
- Dio3 mRNA increased with postoperative ECMO vs no MCS
- P = 0.042
Hcn2 and Myh7 expression, postoperative ECMO vs no MCS
- Hcn2 did not correlate with serum hormone levels
- P = 0.519
- Myh7 did not correlate with serum hormone levels
- P = 0.056
- No significant difference in Hcn2 and Myh7 expression between postoperative ECMO and no MCS
Original publication
The Perioperative Period of Heart Transplantation Is Affected by Thyroid Hormone Status. Thyroid. Published 8 May 2024. doi:10.
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