Hormonal Therapy in Organ Donors

Optimal supportive treatment of brain dead potential organ donors maximizes donation and transplant outcomes. Brain death is associated with activation of inflammatory pathways and loss of autoregulatory brain functions that may include hypothalamic-pituitary dysfunction. As well as general supportive care, specific treatment to counter the common sequelae of brain death such as hypotension, hypothermia, and diabetes insipidus is required. In addition, the provision of specific hormonal therapy (thyroid hormone, vasopressin, and steroids) has been proposed but is controversial due to lack of high level evidence to support its efficacy.