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Vasopressin deficiency and pressor hypersensitivity in hemodynamically unstable organ donors
J M Chen1, S Cullinane, T B Spanier
1Division of Cardiothoracic Surgery, Department of Surgery, Columbia University College of Physicians and Surgeons, New York, NY, USA. jmc23@columbia.edu
Background:
Solid organ donors often develop hypotension due to vasodilation, and recently we observed that a variety of vasodilatory states are characterized by vasopressin deficiency and hypersensitivity. Thus, we investigated the prevalence of vasopressin deficiency in hypotensive solid organ donors without clinical evidence of diabetes insipidus; we also investigated the vasopressor effect of vasopressin replacement in hypotensive donors.
Methods And Results:
Fifty organ donors were evaluated for hemodynamic instability, (mean arterial pressure [MAP]
Conclusions:
Hemodynamically unstable organ donors without clinically apparent diabetes insipidus display a defect in the baroreflex-mediated secretion of vasopressin. In these patients, low-dose vasopressin significantly increases blood pressure with a pressor response sufficient to reduce catecholamine administration.
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