Long-term renal preservation after brain death maintained with vasopressin and epinephrine

In order to examine renal function after brain death, twenty-eight patients were randomly separated into two groups. The systemic blood pressure of ten patients was maintained with epinephrine alone (group 1). Eight of the ten patients experienced cardiac arrest within 48 h (range 6-87 h) despite the rather large dosage of epinephrine. Urine output was uncontrollable and renal function deteriorated progressively in this group. Eighteen patients were maintained with arginine vasopressin and epinephrine (group 2). Circulation was maintained with a smaller dosage of epinephrine than that given group 1 for at least 4 days (mean +/- SD 16.5 +/- 12.2 days). Urine output was controlled within the normal range and serum levels of blood urea nitrogen (BUN) and creatinine were normal for 14 days. Daily creatinine clearance was more than 80 ml/min. The combined administration of arginine vasopressin and epinephrine preserved the kidneys after brain death for more than a week. This method will be of great value in renal transplantation from brain-dead organ donors.