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.