Eficiency of triiodothyronine treatment on organ donor hemodynamic management and adenine nucleotide concentration

• Published in: Intensive care medicine Vol. 31; no. 7; pp. 943 - 948
• Main Authors: PEREZ-BLANCO, Alicia, CATURLA-SUCH, Juan, CANOVAS-ROBLES, José, SANCHEZ-PAYA, José
• Format: Journal Article
• Language: English
• Published: Heidelberg Springer 01.07.2005; Berlin Springer Nature B.V
• Subjects: Adenylic acid; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis; Case studies; Donation of organs, tissues, etc; Emergency and intensive care: injuries, diseases due to physical agents. Diving. Drowning. Disaster medicine; Health aspects; Intensive care medicine; Medical sciences; Organ donors; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Triiodothyronine; United States; Brain-dead donor; Intensive care; Triiodothyronine; Nonthyroidal illness; Pco2 gap; Adenine nucleotides; Brain death; Adenine; B-Vitamins; Clinical management; Treatment; Donor; Gap; Thyroid hormone; Triiodothyronine; Hemodynamics; Resuscitation
• ISSN: 0342-4642; 1432-1238
• DOI: 10.1007/s00134-005-2662-9

We compared hemodynamic values, oxygen utilization, and adenine nucleotide concentration in the extracted organs of brain-dead donors treated with triiodothyronine vs. standard support treatment. Prospective, randomized, double-blind controlled study. We recruited 52 consecutive adult cadaveric organ donors. Inclusion criteria were diagnosis of brain-death, transplantation suitability, and family consent for donation; exclusion criterion was preexisting thyroid disease. The treatment group (n=29) received an intravenous bolus of 1 microg/kg triiodothyronine followed by continuous perfusion at 0.06 microg/kg per hour, and controls (n=23) received 0.9% ClNa delivered over 270 min. Hemodynamics, tonometry, thyroid hormones, and serum lactate were measured every 90 min from brain death to extraction procedure. Biopsies were processed to determine adenine nucleotides concentration. Hemodynamic measurements did not differ significantly in the two groups, and the inotrope dose could not be diminished after treatment. Thyrotropin levels increased from brain death to extraction procedure in controls. Thyrotropin measured 90 and 180 min after the beginning of the perfusion was significantly lower in the treatment group than controls. The Pco2 gap increased in both groups from brain death to the extraction procedure. The lactate level of the treatment group was lower than in controls. Biopsy specimens were obtained in 19 controls and in 20 donors of the treatment group; the adenine nucleotides concentration did not show any significant difference. Triiodothyronine did not add any benefit over the standard management of the organ donor nor did it affect the adenine nucleotides concentration of any biopsied organs.