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Thyroid hormone in the treatment of post-transplant acute tubular necrosis (ATN).

Publication ,  Journal Article
Acker, CG; Flick, R; Shapiro, R; Scantlebury, VP; Jordan, ML; Vivas, C; Greenberg, A; Johnson, JP
Published in: Am J Transplant
January 2002

Delayed graft function (DGF) in cadaver kidney transplants is a common problem and is often due to acute tubular necrosis (ATN). DGF in transplants may have a deleterious effect on long-term graft survival. Since thyroid hormone has been shown to hasten recovery from ATN in experimental models, we designed a trial to determine if a defined course of triiodothyronine (T3) would improve the short- or long-term outcome of patients with DGF in cadaveric transplants. A prospective, randomized, placebo controlled, double blind trial of T3 was carried out in patients with DGF in cadaveric renal transplants. End-points were percentage requiring dialysis, percentage recovering function, time to recovery and length of hospital stay. Long-term outcomes were percentage grafts functioning at 1 year and mean serum creatinine at 1 year. Forty-four patients were randomized to receive either T3 or placebo. Three patients were dropped from each group when early biopsies disclosed that DGF was due to rejection. The groups were well matched by age, cold ischemia time of the graft, and percentage reactivity to a random panel of antigens. Baseline thyroid function studies, including T3, reverse T3 (rT3), and thyroid stimulating hormone (TSH) levels, were similar between the two groups and typical of 'euthyroid-sick syndrome'. T3 had no effect on percentage requiring dialysis, time to recovery, percentage recovering function, or length of stay. At 1 year follow-up, graft function was similar in both groups and significantly lower than that seen in patients with good initial function. Thyroid hormone, given early in the course of DGF in cadaver kidney recipients, had no effect on the course of DGF. Long-term graft function is impaired in patients who experience post-transplant DGF compared to those who have good initial function.

Duke Scholars

Published In

Am J Transplant

DOI

ISSN

1600-6135

Publication Date

January 2002

Volume

2

Issue

1

Start / End Page

57 / 61

Location

United States

Related Subject Headings

  • Triiodothyronine, Reverse
  • Triiodothyronine
  • Time Factors
  • Thyrotropin
  • Surgery
  • Placebos
  • Middle Aged
  • Kidney Tubular Necrosis, Acute
  • Kidney Transplantation
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Acker, C. G., Flick, R., Shapiro, R., Scantlebury, V. P., Jordan, M. L., Vivas, C., … Johnson, J. P. (2002). Thyroid hormone in the treatment of post-transplant acute tubular necrosis (ATN). Am J Transplant, 2(1), 57–61. https://doi.org/10.1034/j.1600-6143.2002.020110.x
Acker, Christopher G., Richard Flick, Ron Shapiro, Velma P. Scantlebury, Mark L. Jordan, Carlos Vivas, Arthur Greenberg, and John P. Johnson. “Thyroid hormone in the treatment of post-transplant acute tubular necrosis (ATN).Am J Transplant 2, no. 1 (January 2002): 57–61. https://doi.org/10.1034/j.1600-6143.2002.020110.x.
Acker CG, Flick R, Shapiro R, Scantlebury VP, Jordan ML, Vivas C, et al. Thyroid hormone in the treatment of post-transplant acute tubular necrosis (ATN). Am J Transplant. 2002 Jan;2(1):57–61.
Acker, Christopher G., et al. “Thyroid hormone in the treatment of post-transplant acute tubular necrosis (ATN).Am J Transplant, vol. 2, no. 1, Jan. 2002, pp. 57–61. Pubmed, doi:10.1034/j.1600-6143.2002.020110.x.
Acker CG, Flick R, Shapiro R, Scantlebury VP, Jordan ML, Vivas C, Greenberg A, Johnson JP. Thyroid hormone in the treatment of post-transplant acute tubular necrosis (ATN). Am J Transplant. 2002 Jan;2(1):57–61.

Published In

Am J Transplant

DOI

ISSN

1600-6135

Publication Date

January 2002

Volume

2

Issue

1

Start / End Page

57 / 61

Location

United States

Related Subject Headings

  • Triiodothyronine, Reverse
  • Triiodothyronine
  • Time Factors
  • Thyrotropin
  • Surgery
  • Placebos
  • Middle Aged
  • Kidney Tubular Necrosis, Acute
  • Kidney Transplantation
  • Humans