ST. LOUIS (Nov. 29, 2023) – Dr. Gary Marklin, Chief Medical and Research Officer at Mid-America Transplant, and co-principal investigator Dr. Rajat Dhar, Washington University School of Medicine, published a study in the New England Journal of Medicine that analyzes the impact of a certain medication in improving the management of donor hearts for transplantation. This marks the first time an organ procurement organization (OPO) was the leader in developing a clinical research study that has been published in what is considered the most prestigious medical journal in the world.
“Our findings refute a decades-long practice in which more than 80% of OPOs used intravenous levothyroxine in managing organ donors to improve cardiac function,” said Dr. Marklin. “The problem was that there was no definitive evidence that justified the use of levothyroxine. Through this study, we proved that levothyroxine provides no benefit to improving cardiac function, and actually causes adverse effects in some cases, such as elevated heart rate and high blood pressure.”
The study included 838 donors from 15 OPOs across the country, half of whom were treated with intravenous levothyroxine while the other half were treated with a saline placebo. Results showed no significant difference in the number of hearts ultimately transplanted from each group of donors. There was also no difference in improving the pump function of the heart, time to wean off blood pressure medications, or total number of other organs transplanted per donor.
“This is a great example of how rigorous clinical research can drive continuous improvement in organ donation,” said Dr. Marklin. “By maximizing donation potential, we are able to be even greater stewards of the lifesaving gifts given to us by donor heroes and their families.”
Previously, Mid-America Transplant conducted a study that demonstrated that shock in organ donors could be effectively treated with a rigorous fluid resuscitation protocol without the need for levothyroxine. The cardiac function improved with the fluid protocol and observation. From there, the OPO followed this new method and stopped using levothyroxine for treatment of donor hearts, with no negative impacts in the number or quality of organs transplanted.
Mid-America Transplant has long been a leader in clinical innovation for managing organ and tissue donors. In addition to research around improving heart quality, Dr. Marklin and Mid-America Transplant have published a number of other industry-first innovations that have led to more lives saved, such as studies examining the ventilation of lung donors reoriented into a prone position and starting dialysis on donors with acute kidney failure after the diagnosis of brain-death. In both cases, these interventions doubled the number of organs transplanted.
The full findings of Dr. Dhar and Dr. Marklin’s research can be found in the New England Journal of Medicine. The publication is recognized as the world’s leading medical journal, providing high-quality, peer-reviewed research and interactive clinical content to physicians, educators, researchers, and the global medical community for more than 200 years.
Organ and tissue donors can save up to eight lives, restore sight to two people and heal another 75 people through tissue donation. Register to be a donor at www.SayYesGiveLife.org.
About Mid-America Transplant
Mid-America Transplant enables adults and children to receive lifesaving gifts through organ and tissue donations. For nearly 50 years, it has facilitated and coordinated organ, tissue, and eye donation, and now serves 84 counties covering eastern Missouri, southern Illinois and northeast Arkansas that together are home to 4.7 million people. It saves lives by providing expert and compassionate care for organ donors, recipients and families, and transforms the clinical processes required to recover and transplant organs and tissues. Mid-America Transplant was the first such organization in the U.S. to use an in-house operating room for organ recovery and pioneered innovative models of increasing donor registry enrollment to provide organs and tissues to those in need. It is federally designated as one of 56 such organizations in the U.S. and is the first organ procurement organization (OPO) to be recognized as a recipient of the Malcolm Baldrige National Quality Award for Performance Excellence, and the only two-time recipient. For more information, visit www.midamericatransplant.org.