Van Thiel D H, Udani M, Schade R R, Sanghvi A, Starzl T E
Hepatology. 1985 Sep-Oct;5(5):862-6. doi: 10.1002/hep.1840050526.
The thyroid hormones T4, T3, rT3 and TSH were assayed in 134 adult patients evaluated and accepted as potential liver transplant candidates at the University of Pittsburgh from March, 1981 to December, 1983. The subsequent course of these patients was evaluated with respect to the levels of these hormones obtained at the time of acceptance for transplantation. T4 levels were increased significantly while their T3 levels were reduced (both p less than 0.01) in those who survived and were discharged home as compared to either those who died waiting to be transplanted or died following the procedure. As a result, the ratio of T3/T4 was reduced markedly (p less than 0.01) in those who were transplanted and survived as compared to those not transplanted or dying following transplantation. Importantly, the rT3 levels clearly separated (p less than 0.01) those who would die prior to transplantation from those who would survive to be transplanted. Finally, the ratio rT3/T3 even more clearly separates those who will die prior to transplantation (p less than 0.01) from the other two groups. These data suggest that thyroid hormone levels, particularly rT3 levels, might be useful in setting priorities for which patients referred for a transplantation evaluation should be accepted into the program and in determining who among accepted patients should be operated upon in preference to others also accepted and waiting to be transplanted.
1981年3月至1983年12月期间，在匹兹堡大学对134名成年患者进行了甲状腺激素T4、T3、反T3（rT3）和促甲状腺激素（TSH）的检测，这些患者被评估并被接受为潜在的肝移植候选者。根据移植接受时所获得的这些激素水平，对这些患者随后的病程进行了评估。与那些在等待移植过程中死亡或术后死亡的患者相比，存活并出院回家的患者T4水平显著升高，而T3水平降低（两者p均小于0.01）。因此，与未移植或移植后死亡的患者相比，移植后存活的患者T3/T4比值明显降低（p小于0.01）。重要的是，rT3水平清楚地将移植前死亡的患者与能够存活至移植的患者区分开来（p小于0.01）。最后，rT3/T3比值更清楚地将移植前死亡的患者与其他两组区分开来（p小于0.01）。这些数据表明，甲状腺激素水平，特别是rT3水平，可能有助于确定哪些转诊进行移植评估的患者应被纳入该项目的优先顺序，以及在已接受的患者中确定哪些患者应优先于其他同样被接受并等待移植的患者进行手术。
