Salim Ali, Martin Matthew, Brown Carlos, Inaba Kenji, Roth Bradley, Hadjizacharia Pantelis, Mascarenhas Angela, Rhee Peter, Demetriades Demetrios
Division of Trauma and Critical Care, Department of Surgery, University of Southern California Keck School of Medicine, Los Angeles, CA 90033, USA.
Clin Transplant. 2007 May-Jun;21(3):405-9. doi: 10.1111/j.1399-0012.2007.00659.x.
The aggressive management of brain-dead (cadaveric) organ donors has been shown to increase organs available for transplantation. Some centers use hormone therapy with thyroid hormone (T(4)) in selected donors. The purpose of this study is to evaluate the effects of T(4) on organs available for transplantation. A policy of aggressive donor management was adopted at our trauma center in 1998. T(4) therapy is reserved for the hemodynamically unstable donors who require significant vasopressor support. The records of patients who successfully donated organs between January 2001 and December 2005 were reviewed. Organ donor demographics and whether T(4) was used was examined for each donor. T(4) was used in 96 of 123 donors (78%). Compared with donors who did not receive T(4), those that did were similar in age (32 +/- 14 vs. 38 +/- 21, p = 0.148), had more organs donated (3.9 +/- 1.7 vs. 3.2 +/- 1.7, p = 0.048), and had no differences in brain-death related complications. Despite the severe hemodynamic instability in the T(4) group, the number of organs harvested from this group was significantly more than in patients who did not receive T(4). The use of T(4) in this group may result in the increased salvage of transplantable organs.
对脑死亡（尸体）器官捐献者采取积极管理措施已被证明可增加可供移植的器官数量。一些中心在特定的捐献者中使用甲状腺激素（T4）进行激素治疗。本研究的目的是评估T4对可供移植器官的影响。1998年我们的创伤中心采用了积极的捐献者管理政策。T4治疗仅用于那些需要大量血管升压药支持且血流动力学不稳定的捐献者。回顾了2001年1月至2005年12月期间成功捐献器官的患者记录。检查了每个捐献者的器官捐献者人口统计学资料以及是否使用了T4。123名捐献者中有96名（78%）使用了T4。与未接受T4的捐献者相比，接受T4的捐献者年龄相仿（32±14岁对38±21岁，p = 0.148），捐献的器官更多（3.9±1.7个对3.2±1.7个，p = 0.048），且与脑死亡相关的并发症无差异。尽管T4组存在严重的血流动力学不稳定，但该组获取的器官数量明显多于未接受T4的患者。该组使用T4可能会增加可移植器官的挽救率。
