Document Detail


Terlipressin in brain-death donors.
MedLine Citation:
PMID:  23121213     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: 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.
METHOD: 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.
Authors:
Ornella Piazza; Giuliana Scarpati; Fabio Rispoli; Michele Iannuzzi; Rosalba Tufano; Edoardo De Robertis
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review     Date:  2012-11-02
Journal Detail:
Title:  Clinical transplantation     Volume:  26     ISSN:  1399-0012     ISO Abbreviation:  Clin Transplant     Publication Date:    2012 Nov-Dec
Date Detail:
Created Date:  2012-12-10     Completed Date:  2013-05-28     Revised Date:  2013-08-05    
Medline Journal Info:
Nlm Unique ID:  8710240     Medline TA:  Clin Transplant     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  E571-5     Citation Subset:  IM    
Copyright Information:
© 2012 John Wiley & Sons A/S.
Affiliation:
Anestesiologia e Rianimazione, Università degli Studi di Salerno, Baronissi, Salerno, Italy. opiazza@unisa.it
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MeSH Terms
Descriptor/Qualifier:
Brain Death*
Humans
Hypotension / drug therapy*
Lypressin / analogs & derivatives*,  therapeutic use
Organ Transplantation*
Tissue Donors
Vasoconstrictor Agents / therapeutic use*
Chemical
Reg. No./Substance:
0/Vasoconstrictor Agents; 14636-12-5/terlipressin; 50-57-7/Lypressin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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