Improved Survival of Pediatric Heart Transplant Recipients with Donor Thyroxine Management: Is it Age-Dependent?

Purpose Studies on the efficacy of pre-recovery donor thyroxine (T4) treatment for adult heart transplant recipients report inconsistent results. Guidelines for T4 therapy in donors designated for pediatric heart transplantation (PHT) remain undefined. This study investigates the age-dependent impact of donor T4 therapy on the survival of PHT recipients. Methods The UNOS Registry was queried for PHT recipients ( Results A total of 7,999 PHT recipients were identified. 51.5% received a T4-treated donor heart. Median age of patients receiving a T4-treated heart (5 yrs) was significantly higher than those transplanted with non-treated hearts (3 yrs; p Conclusion Survival benefit of donor T4 treatment in PHT depends mainly on recipient age, demonstrating a nonlinear relationship according to donor age. Better survival is seen in infants transplanted with T4-treated hearts. Future clinical trials are warranted to confirm indications for T4 therapy.