Levothyroxine Use in Brain-Dead Organ Donors

Historical Guideline Position

• The American College of Cardiology guidelines stated that thyroid hormone supplementation should NOT be routinely used in brain-dead donors, noting that "the efficacy of such therapy is unproved" 1

Alternative Hemodynamic Management

• The American College of Cardiology recommends fluid resuscitation with 1000 mL balanced salt solution bolus, hourly maintenance fluids of 100-150 mL plus urinary output replacement, dopamine for hypotension, and vasopressin for diabetes insipidus, with meticulous electrolyte management, particularly potassium supplementation 1, 2
• The American College of Cardiology suggests prioritizing conventional hemodynamic support with fluids and vasopressors 1, 2