Thyroxine Replacement in Organ Donors

NCT ID: NCT00238030

Last Updated: 2011-01-05

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE1/PHASE2

Total Enrollment

34 participants

Study Classification

INTERVENTIONAL

Study Start Date

2004-12-31

Study Completion Date

2010-10-31

Brief Summary

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To compare oral versus intravenous administration of thyroid hormone: 1) for reversibility of hemodynamic instability in organ donors, and, 2) the pharmacokinetics of oral vs iv thyroid administration

Detailed Description

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Disruption of the hypothalamic-pituitary axis following brain death may lead to hemodynamic instability, peripheral vasodilation, and diabetes insipidus in organ donors, requiring the use of high doses of inotropes. Inotropes may cause ischemic injury to organs and intramyocardial ATP stores, resulting in organs unsuitable for transplantation, as well as, a reduction in post-transplant organ function. Therefore, some clinicians advocate the use of triple hormonal therapy in potential organ donors.

Since intravenous T3(the intracellular active form of thyroxine) is unavailable, oral or intravenous T4 must be used, requiring the conversion of T4 to T3at the cellular level. This conversion is impeded by glucocorticoids which also are administered to organ donors for their immunomodulating effects. Since oral T3 is readily available, our first question is whether oral versus intravenous administration of T4 is comparable. If so, our next study is to determine the efficacy of oral T3 versus oral T4. Our hypothesis is oral T3 is superior to oral T4.

Our study therefore will determine whether or not the oral route is suitable for administration of thyroid replacement therapy. The study will compare the pharmacokinetics of oral versus intravenous T4 administration in organ donors, as well as, determine its ability to wean intropes in this patient population.

Conditions

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Brain Death

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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po thyroxine

placebo is iv

Group Type ACTIVE_COMPARATOR

L-thryoxine

Intervention Type DRUG

2 mcg/kg iv or 2 mcg/kg po at time of enrollment

iv thryoxine

Intervention Type DRUG

thyroxine 2 mcg/kg iv

iv thyroxine

placebo is po

Group Type ACTIVE_COMPARATOR

iv thryoxine

Intervention Type DRUG

thyroxine 2 mcg/kg iv

Interventions

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L-thryoxine

2 mcg/kg iv or 2 mcg/kg po at time of enrollment

Intervention Type DRUG

iv thryoxine

thyroxine 2 mcg/kg iv

Intervention Type DRUG

Other Intervention Names

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L-thyroxine Eltroxin L-thyroxine Eltroxin

Eligibility Criteria

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Inclusion Criteria

1. Brain death criteria established
2. Consent for organ donation received

Exclusion Criteria

1\. immediate (\< 4 Hrs) organ retrieval anticipated
Minimum Eligible Age

16 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph's

OTHER

Sponsor Role lead

Responsible Party

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London Health Sciences Centre - University Hospital

Principal Investigators

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Michael D Sharpe, MD FRCPC

Role: PRINCIPAL_INVESTIGATOR

London Health Sciences Centre-UC+

Locations

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London Health Sciences Centre-UC

London, Ontario, Canada

Site Status

Countries

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Canada

References

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Novitzky D, Cooper DK, Chaffin JS, Greer AE, DeBault LE, Zuhdi N. Improved cardiac allograft function following triiodothyronine therapy to both donor and recipient. Transplantation. 1990 Feb;49(2):311-6. doi: 10.1097/00007890-199002000-00017.

Reference Type BACKGROUND
PMID: 2305461 (View on PubMed)

Sharpe MD, van Rassel B, Haddara W. Oral and intravenous thyroxine (T4) achieve comparable serum levels for hormonal resuscitation protocol in organ donors: a randomized double-blinded study. Can J Anaesth. 2013 Oct;60(10):998-1002. doi: 10.1007/s12630-013-0004-x. Epub 2013 Jul 25.

Reference Type DERIVED
PMID: 23884915 (View on PubMed)

Other Identifiers

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R-04-298

Identifier Type: -

Identifier Source: org_study_id

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