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Terlipressin in brain-death donors
Ornella Piazza1, Giuliana Scarpati, Fabio Rispoli
1Anestesiologia e Rianimazione, Università degli Studi di Salerno, Baronissi, Salerno, Italy. opiazza@unisa.it
Clinical Transplantation
|November 6, 2012
Summary
Terlipressin effectively manages hypotension in brain-death organ donors, reducing the need for norepinephrine. Further research is needed to establish its therapeutic range and side effects.
Area of Science:
- Nephrology
- Endocrinology
- Critical Care Medicine
Background:
- Brain death causes hormonal imbalances, impairing circulatory function in organ donors.
- Vasopressin deficiency post-brain death leads to hypotension.
- Terlipressin, a vasopressin analog, offers potential pressor support.
Purpose of the Study:
- To summarize the pharmacology and literature of terlipressin in shock, particularly neurogenic shock after brain death.
- To report personal experience with terlipressin in brain-dead organ donors.
Main Methods:
- Literature review on terlipressin's use in shock and neurogenic shock.
- Analysis of personal clinical experience with terlipressin in organ donors.
Main Results:
- Terlipressin demonstrated efficacy in controlling severe hypotension.
- Two of three brain-dead organ donors required approximately 50% less norepinephrine infusion after terlipressin administration.
Conclusions:
- Terlipressin is beneficial for managing severe hypotension in brain-dead organ donors.
- More data are required to determine terlipressin's therapeutic range and graft-related side effects.
