Conflict of interest: The authors have no conflict of interests to disclose.
Terlipressin in brain-death donors
Article first published online: 2 NOV 2012
© 2012 John Wiley & Sons A/S.
Volume 26, Issue 6, pages E571–E575, November/December 2012
How to Cite
Terlipressin in brain-death donors., , , , , .
- Issue published online: 6 DEC 2012
- Article first published online: 2 NOV 2012
- Manuscript Accepted: 28 AUG 2012
- brain death;
- neurogenic shock;
Metabolic management of brain-death organ donors includes correction of the hormonal perturbations that occur after cerebral death and impair circulatory function. Vasopressin is a hormone secreted by the posterior pituitary gland, which contributes to maintain systemic blood pressure by regulating urine secretion and small arteriole tonus. During brain death, the pituitary gland is damaged and hormone secretion rapidly ceases. Low-dose vasopressin increases systemic blood pressure and decreases the need for catecholamines in brain-dead organ donors but it is not available in many countries. Terlipressin is a synthetic analog of vasopressin characterized by greater selectivity for the V1 receptor than vasopressin. To date, the efficacy of terlipressin as a pressor agent in humans has been reported in a few studies.
Pharmacology and literature about the use of terlipressin in shock and in particularly in neurogenic shock following brain death is summarized and our personal experience is reported.
Results and conclusion
Terlipressin is helpful in controlling severe hypotension; its use allowed to reduce the infusion rate of norepinephrine about 50% in two of three brain-death organ donors, but there are not yet enough data to define its therapeutic range and incidence of collateral effects on the grafts.