Do thyroid disorders affect the postoperative course of patients in the early post-heart transplant period?

Kowalczuk-Wieteska, Anetta; Barańska-Kosakowska, Anna; Zakliczyńśki, Michał; Lindon, Sandra; Zembala, Marian

doi:10.12659/aot.881998

Cited by 11 publications

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“…In terms of thyroid disorders, recent studies suggest that hyperthyroidism is present in 21%, hypothyroidism in 13%, and low fT3 syndrome in 18 patients within 1 month after HT respectively [20]. Our results corroborate these data, as hyperthyrosis was established in 10% and hypothyrosis in 5% of the studied cohort.…”

Section: Discussionsupporting

confidence: 91%

“…Our results corroborate these data, as hyperthyrosis was established in 10% and hypothyrosis in 5% of the studied cohort. Clinical effects of thyroid disorders after HT are substantial, as hypothyroidism is linked to increased length of hospitalization, and cytomegaloviral infections occur most commonly in patients with hyperthyroidism [20]. Atrial fibrillation could be associated with hyperthyroidism, but was not observed in our patient cohort within the first post-HT year.…”

Section: Discussionmentioning

confidence: 68%

“…The prevalence of secondary hyperparathyroidism after HT, ranging from 30 to 75%, has been assessed in only a few studies [6,17,18]. Similarly, thyroid function in the early post-transplant period has remained largely unaddressed [19][20][21].…”

Section: Introductionmentioning

confidence: 99%

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Endocrine disorders after heart transplantation: national cohort study

et al. 2020

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Background: Endocrine disorders in patients after heart transplantation (HT) remain understudied. We aimed to assess endocrine profiles and management of HT recipients in the early post-transplant period. Methods: We conducted a retrospective cohort study on 123 consecutive HT recipients in the Advanced Heart Failure and Transplantation Programme between 2009 and 2018. All recipients had per-protocol endocrine followup within the first postoperative year. The median time to first post-transplant endocrine follow-up was 3 months (IQR 2-4). We assessed the incidence of vitamin D deficiency, bone mineral density, history of low energy fractures, hypogonadism in male recipients, posttransplant diabetes mellitus, and thyroid and parathyroid function. Results: We enrolled 22 women and 101 men of median age 57 years (IQR 50-63). Post-transplant diabetes mellitus developed in 14 patients (11.4%). 18 of 25 patients (14.6%) with preexisting type 2 diabetes mellitus required intensification of antidiabetic therapy. 38 male patients (40.4%) had hypogonadism. 5 patients (4.6%) were hypothyroid and 10 (9.3%) latent hyperthyroid. Secondary hyperparathyroidism was present in 19 (17.3%), 25hydroxyvitamin D deficiency in 64 (54.7%) of patients. Osteoporosis was present in 26 (21.1%), osteopenia in 59 (48.0%) patients. 47 vertebral fractures, 3 hip and 1 humerus fractures occurred in 21 patients. Most of the patients had coincidence of two or three disorders, while less than 5% did not have any endocrine irregularities. All patients received calcium and vitamin D supplements. Forty-six patients (37.4%) were treated with zoledronic acid, 12 (9.8%) with oral bisphosphonates. Two patients were treated with teriparatide. Conclusions: The prevalence of multiple endocrine disorders early after heart transplantation is high. Assessment and management of increased fracture risk and all other potentially affected endocrine axes should be considered as a standard of care in this early period.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 68%

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Endocrine disorders after heart transplantation: national cohort study

et al. 2020

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“…Postoperative usage of high-dose steroids reduces the plasma levels of TSH, FT 3 , and FT 4 . It is reported that oral use of methyl prednisolone of 20 mg once a day for seven days causes a reduction in TSH with no change in FT 3 , FT 4 , or thyroid-binding-globulin [ 3 – 5 ].…”

Section: Discussionmentioning

confidence: 99%

“…It enhances postoperative haemodynamic stability and reduces arrhythmia incidence. Hypothyroidism reduces average and maximum heart rate and usually causes sinus bradycardia and atrioventricular blocks [ 4 , 5 ]. It leads to haemodynamic deterioration via cardiac dysfunctions.…”

Section: Discussionmentioning

confidence: 99%

Hypothyroidism complicates bradyarrhythmic episodes in a heart-transplanted patient: Can it be treated with low-dose dopamine?

Cingoz¹

2015

kitp

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Extracorporeal circulation decreases thyroid hormone levels in peripheral blood. This clinical entity may complicate the postoperative period after heart transplantation if the recipient has taken thyroid hormone replacement therapy. Cardiac transplantation was performed on a patient in whom thyroid hormone levels decreased after surgery. Sinus bradycardia was seen after surgery (30-40 bpm). Thyroid hormones were replaced in the patient. Due to the fact that temporary pacing decreased blood pressure, dopamine was safely given in very low doses. This case was discussed under the literature knowledge.

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Endocrine and Metabolic Emergencies in Transplantation

Wermers¹,

Shah²

2018

Endocrine and Metabolic Medical Emergencies

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Do thyroid disorders affect the postoperative course of patients in the early post-heart transplant period?

Cited by 11 publications

References 0 publications

Endocrine disorders after heart transplantation: national cohort study

Endocrine disorders after heart transplantation: national cohort study

Hypothyroidism complicates bradyarrhythmic episodes in a heart-transplanted patient: Can it be treated with low-dose dopamine?

Endocrine and Metabolic Emergencies in Transplantation

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