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

ABSTRACT

BACKGROUND: Thyroid hormones are essential for the correct functioning of the entire body. Diagnosis of thyroid disorders in patients after heart transplant in the early post-operative period and the implementation of correct treatment may prevent life-threatening complications. MATERIAL/METHODS: The aim of the study was to determine whether the complicated postoperative course (ie, hypothyroidism, hyperthyroidism or low fT3 syndrome) in patients in the first month after heart transplantation was connected with impaired thyroid hormone management. The analysis encompassed material from 98 patients treated with heart transplantation between February 9, 2004 and January 4, 2010. Hyperthyroidism was diagnosed in 21 patients (19M/2F, 52±7 years of age), hypothyroidism in was diagnosed in 13 patients (10M/3F, 46±12 years old), and low fT3 syndrome was diagnosed in 18 patients (14M/4F, 43±12 years old). RESULTS: Patients with fT3 syndrome had the highest mortality (16.7%, NS), highest incidence of acute rejection (38.9%, NS), highest number of reoperations (27.8%, NS), and highest incidence of bacterial (16.7%, NS) and fungal infections (11.1%, NS). Cytomegaloviral infections occurred most frequently in patients with hyperthyroidism (23.8%, NS). Patients with hypothyroidism (84.6%, NS) were hospitalized the longest (>30 days), had the highest tendency towards pleural effusion (23.1%, NS) and pericardial effusion with tamponade (15.5%, NS), bradycardia with pacemaker (15.4%, NS) and renal failure requiring hemodiafiltration (15.4%, NS) (Table 1). CONCLUSIONS: 1. The thyroid test panel should be performed in all patients in the early post-heart transplant period. 2. The diagnosis of thyroid disorders should be immediately followed by correct treatment aimed at restoring the euthyroid state, with a view to facilitate recovery and rehabilitation as well as to shorten the hospitalization time, thereby lowering treatment costs.