Korean J Crit Care Med.  2008 Jun;23(1):30-35. 10.4266/kjccm.2008.23.1.30.

Hormonal Changes of the Brain-Dead Organ Donors: A 3-Year Experience

• Choi YS
• Na S
• Kang SY
• Koh SO

• KMID: 2228432
• DOI: http://doi.org/10.4266/kjccm.2008.23.1.30

Abstract

BACKGROUND: Success of transplantation is critically dependent upon the quality of the donor organ and optimal management. Recently, hormonal replacement therapy has been reported to result in rapid recovery of cardiac function and enable significantly more organs to be transplanted, while some other studies show conflicting results. The aim of this study is to comprehensively evaluate changes in basal circulating hormonal levels of the brain-dead organ donors.
METHODS
We reviewed the records of all brain-dead patients between January, 2004, and June, 2007. Hemodynamic variables, plasma hormone levels were recorded at following time points: admission to the ICU (T1, baseline), 30 minutes (min) after first apnea test (T2), 30 min after second apnea test (T3), before operation for harvesting (T4). Hormonal measurements included cortisol, adrenocorticotrophic hormone, triiodothyronine (T(3)), thyroxine, free thyroxine, thyroid-stimulating hormone, growth hormone, and testosterone.
RESULTS
Nineteen patients were included in this study. Comparisons of hemodynamic parameters and hormonal levels to baseline values revealed no significant changes throughout the study period. When the patients were divided into 2 groups according to the requirement of norepinephrine (either>0.05 or < or =0.05microgram/kg/min), patients requiring >0.05microgram/kg/min of norepinephrine had T(3) level below the normal range at significantly more time points of measurement (7 vs. 0).
CONCLUSION
In this comprehensive assessment of hormonal levels in brain-dead organ donors, we could not observe any significant changes during the ICU stay. Replacement therapy of T(3) may be considered in patients requiring >0.05microgram/kg/min of norepinephrine.

Keyword

Brain-dead organ donors; Hormonal replacement therapy; Thyroid hormone levels; Vasopressor

MeSH Terms

Adrenocorticotropic Hormone
Apnea
Growth Hormone
Hemodynamics
Humans
Hydrocortisone
Norepinephrine
Plasma
Reference Values
Testosterone
Thyrotropin
Thyroxine
Tissue Donors
Transplants
Triiodothyronine
Adrenocorticotropic Hormone
Growth Hormone
Hydrocortisone
Norepinephrine
Testosterone
Thyrotropin
Thyroxine
Triiodothyronine