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The fundamental study and its clinical application of the thyroid autotransplantation for the patients with permanent postoperative hypothyroidism.

Research Project

Project/Area Number 09671262
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeSingle-year Grants
Section一般
Research Field General surgery
Research InstitutionNippon Medical School

Principal Investigator

SHIMIZU Kazuo  Nippon Medical School Department of Surgery II Professor, 医学部, 教授 (20133449)

Co-Investigator(Kenkyū-buntansha) AKASU Haruki  Nippon Medical School Department of Surgery II Professor, 医学部, 助手 (30297866)
KITAGAWA Wataru  Nippon Medical School Department of Surgery II Clinical instructor, 医学部, 助手 (80297895)
TANAKA Shigeo  Nippon Medical School Department of Surgery II Professor, 医学部, 教授 (70089720)
北村 裕  日本医科大学, 医学部, 助手 (90297896)
Project Period (FY) 1997 – 2000
Project Status Completed (Fiscal Year 2000)
Budget Amount *help
¥2,600,000 (Direct Cost: ¥2,600,000)
Fiscal Year 2000: ¥100,000 (Direct Cost: ¥100,000)
Fiscal Year 1999: ¥200,000 (Direct Cost: ¥200,000)
Fiscal Year 1998: ¥100,000 (Direct Cost: ¥100,000)
Fiscal Year 1997: ¥2,200,000 (Direct Cost: ¥2,200,000)
Keywordscryopreservation / autotransplantation / postoperative hypothyroidism / Graves' disease / 永続的甲状腺機能低下症 / バセドウ病 / 外科治療 / 連結保存
Research Abstract

Summary
Background Some patients with Graves' disease require life-long levo-thyroxime (l-T4) replacement therapy due to irreversible postoperative hypothyroidism despite the choice of surgical therapy in order to discontinue talking anti-thyroid drug. The aims of this study are to entrust the production of thyroid hormone to the autotransplanted thyroid tissue that had been cryopreserved since initial thyroid surgery, and to release these patients from taking lifelong l-T4 administration.
Methods At the time of subtotal thyroidectomy for Graves' disease, approximately 5 g of surgical specimen was cut into small pieces (less than 1 mm^3) and placed at 4℃ for one hour and at -80℃ for overnight in order and cryopreserved at -196℃ until used for autotransplantation. Four patients underwent autotransplantation of cryopreserved thyroid tissues under local anesthesia for the treatment of postoperative hypothyroidism with obtaining sufficient informed consent. Since these patients required 100〜 … More 150μg/day of l-T4 at the postoperative point of 1.8, 3.4, 3.5 and 2.8 years respectively, 2.5 to 5.0 g of cryopreserved thyroid tissues were autotransplanted into forearm muscle to each patient.
Findings Three patients could discontinue l-T4 administration and clinical symptoms of hypothyroidism disappeared with improvement of serum TSH level until 6 to 12 weeks after transplantation. Pathological and immunohistochemical examination demonstrated well-preserved thyroid structure and thyroglobulin-positive follicular cells and colloids suggesting functional ability of transplants. ^<123>I scintiscanning examined in case 1 and 2 also indicated accumulation of radioactive iodine at the transplantation sites. One patient required l-T4 again because of recurrent hypothyroidism despite having discontinued l-T4 administration for one year.
Interpretation The occupation of the first patient is a school teacher and always has an opportunity to transfer. The second patient has two small babies and a disable husband. Because of the personal circumstances, they were anxious to whether they have to keep going hospital periodically and to take life-long l-T4. Despite the choice of surgical treatment to discontinue medication, those four patients presented here had to reversibly take l-T4. Despite a few remaining uncertainties to reach the final goal, autotransplantation of the cryopreserved thyroid tissue will be one of the useful methods which the patient can choose as one of the therapeutic procedures for treatment of permanent postoperative hypothyroidism in patient with Graves' disease in future. Less

Report

(5 results)
  • 2000 Annual Research Report   Final Research Report Summary
  • 1999 Annual Research Report
  • 1998 Annual Research Report
  • 1997 Annual Research Report
  • Research Products

    (14 results)

All Other

All Publications (14 results)

  • [Publications] 清水一雄: "薬物療法マニュアル・甲状腺機能亢進症"臨床外科. 54. 197-200 (1999)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2000 Final Research Report Summary
  • [Publications] Kazuo Shimizu: "New treatment for permanent postoperative hypothyroidism in patient with Graves' disease-Autotrahsplantation of cryopreserved thyroid tissue (Repart of fourcases)"J Am Coll Surg. (Submitting).

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2000 Final Research Report Summary
  • [Publications] 清水一雄: "プライマリケア/主要疾患・症候群(甲状腺機能亢進症)"医学評論社(監修:伊東洋,庄司進一). 325 (2000)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2000 Final Research Report Summary
  • [Publications] 清水一雄: "薬物療法マニュアル・甲状腺機能亢進症."臨床外科. 54. 197-200 (1999)

    • Related Report
      2000 Annual Research Report
  • [Publications] Kazuo Shimizu: "Autotransplantation of cryopreserved thyroid tissue for permanent postoperative hypothyroidism."J Am Coll Surg (Submitting).

    • Related Report
      2000 Annual Research Report
  • [Publications] 清水一雄: "プライマリケア/主要疾患・症候群(甲状腺機能亢進症)"医学評論社(監修:伊東洋,庄司進一). 325 (2000)

    • Related Report
      2000 Annual Research Report
  • [Publications] 清水 一雄: "薬物療法マニュアル甲状腺機能亢進症"臨床外科. 54. 197-200 (1999)

    • Related Report
      1999 Annual Research Report
  • [Publications] Kazuo Shimizu: "Gutotrans plantation of cryopreserved *****d tissue for permanent postoperative by po***roidism-Report of the 4 cases."J. Clin Inve** (submitting.

    • Related Report
      1999 Annual Research Report
  • [Publications] 伊藤國彦 清水一雄: "甲状腺疾患診療実践マニュアル"文光堂. 232 (1999)

    • Related Report
      1999 Annual Research Report
  • [Publications] Kazuo Shimizu: "Outctrensplantation of cryopreserved thyroid tissue for permanent postoperative bypotheroidism in patients with Graves disease" JCEM. Submitleny.

    • Related Report
      1998 Annual Research Report
  • [Publications] Kazuo Shimizu: "Autotrastsplantation of oryopreserved thyroid tissue for the treatment of inevorsiblepostoperative hypothyrotd Greves'disease.Report of the first case." Thyroidol.Chin.Exp.9. 23-27 (1997)

    • Related Report
      1997 Annual Research Report
  • [Publications] Kazuo Shimizu: "Surgical indications in Hashimoto's thyroiditis" Thyroidol.Chin.Exp.8. 95-101 (1996)

    • Related Report
      1997 Annual Research Report
  • [Publications] 清水一雄: "バセドウ病術后永続的甲状腺機能低下症に対する新しい治療の試み-連結保存甲状腺組織の自家移植(基礎から臨床へ)" 第25回内分泌代謝研究会. (1997)

    • Related Report
      1997 Annual Research Report
  • [Publications] 清水一雄: "国試外科学I(出版予定)" 医学評論社, (1998)

    • Related Report
      1997 Annual Research Report

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Published: 1997-04-01   Modified: 2016-04-21  

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