Schwartz I, Bird S, Lotz Z, Innes C R, Hickman R
Department of Surgery, University of Cape Town, South Africa.
Transplantation. 1993 Mar;55(3):474-6. doi: 10.1097/00007890-199303000-00003.
This study was conducted to determine whether the administration of tri-iodothyronine (T3) to brain-dead donor pigs would improve hemodynamic instability, serum levels of thyroid hormones, or the outcome of transplantation of donor livers. Brain death was caused in young pigs (25-38 kg) by rapid inflation of an intracranially implanted balloon catheter. The animals were maintained on a ventilator and frequent measurements of acid/base balance, electrolytes, and glucose were made. At the end of 16 hr, livers were removed and implanted into prepared recipients. Serum-free tri-iodothyronine fell to zero at the end of 16 hr, and there was a 4-6-fold decline in free thyroxine (T4). The levels of serum reverse T3 (rT3) however, increased up to 6-fold. In animals treated with tri-iodothyronine 2 micrograms/hr, the serum levels of free T3 and T4 were not changed but the levels of serum reverse T3 (rT3) increased further. There were no apparent correlations between any hemodynamic parameter and serum thyroid hormone levels in the donors. After the liver transplants, recipients could be divided into those that survived longer than 6 days and those that did not. Although there were significant differences in the plasma levels of alanine aminotransferase, aspartate aminotransferase, and alkaline phosphatase, there was no correlation between survival and whether the donor had received tri-iodothyronine. Although other hormones, including insulin and cortisol, may also be necessary, there is no indication from these studies that the administration of tri-iodothyronine to brain-dead donors of liver grafts benefits the serum hormone levels in the donors or the subsequent survival of the recipients.
本研究旨在确定对脑死亡供体猪给予三碘甲状腺原氨酸（T3）是否会改善血流动力学不稳定、甲状腺激素血清水平或供体肝脏移植的结果。通过快速充胀颅内植入的球囊导管使幼猪（25 - 38千克）脑死亡。动物通过呼吸机维持，并频繁测量酸碱平衡、电解质和葡萄糖。16小时结束时，取出肝脏并植入准备好的受体。无血清三碘甲状腺原氨酸在16小时结束时降至零，游离甲状腺素（T4）下降了4至6倍。然而，血清反三碘甲状腺原氨酸（rT3）水平升高至6倍。在用每小时2微克三碘甲状腺原氨酸治疗的动物中，游离T3和T4的血清水平未改变，但血清反三碘甲状腺原氨酸（rT3）水平进一步升高。供体中任何血流动力学参数与血清甲状腺激素水平之间均无明显相关性。肝脏移植后，受体可分为存活超过6天和未存活超过6天的两组。尽管丙氨酸氨基转移酶、天冬氨酸氨基转移酶和碱性磷酸酶的血浆水平存在显著差异，但存活与供体是否接受三碘甲状腺原氨酸之间并无相关性。虽然包括胰岛素和皮质醇在内的其他激素可能也很必要，但这些研究并未表明对肝移植脑死亡供体给予三碘甲状腺原氨酸对供体的血清激素水平或受体的后续存活有益。
