Vasopressin Use in the Support of Organ Donors: Physiological Rationale and Review of the Literature

作者：Sofiane Ouerd, Anne Julie Frenette, David Williamson, Karim Serri, Frédérick D’Aragon, Daniel G. Bichet, Emmanuel Charbonney · 发表于：Critical Care Explorations · 年份：2023 · DOI：10.1097/cce.0000000000000907 · 被引用次数：11 · 研究领域：Organ Donation and Transplantation、Organ Transplantation Techniques and Outcomes、Palliative Care and End-of-Life Issues

The objective of this review was to depict the physiological and clinical rationale for the use of vasopressin in hemodynamic support of organ donors. After summarizing the physiological, pharmacological concepts and preclinical findings, regarding vasopressin's pathophysiological impacts, we will present the available clinical data. DATA SOURCES: Detailed search strategies in PubMed, OVID Medline, and EMBASE were undertaken using Medical Subject Headings and Key Words. STUDY SELECTION: Physiological articles regarding brain death, and preclinical animal and human studies about the use of vasopressin or analogs, as an intervention in organ support for donation, were considered. DATA EXTRACTION: Two authors independently screened titles, abstracts, and full text of articles to determine eligibility. Data encompassing models, population, methodology, outcomes, and relevant concepts were extracted. DATA SYNTHESIS: Following brain death, profound reduction in sympathetic outflow is associated with reduced cardiac output, vascular tone, and hemodynamic instability in donors. In addition to reducing catecholamine needs and reversing diabetes insipidus, vasopressin has been shown to limit pulmonary injury and decrease systemic inflammatory response in animals. Several observational studies show the benefit of vasopressin on hemodynamic parameters and catecholamine sparing in donors. Small trials suggest that vasopressin increase organ procurement and have some survival benefit for r...