Aggressive pharmacologic donor management results in more transplanted organs

TitleAggressive pharmacologic donor management results in more transplanted organs
Publication TypeJournal Article
Year of Publication2003
AuthorsRosendale JD, Kauffman HM, McBride MA, Chabalewski FL, Zaroff JG, Garrity ER, Delmonico FL, Rosengard BR
Pagination482 - 7
Date Published46419
Accession Number12605114
Keywords*Brain Death, Adult, Child, Child, Preschool, Humans, Middle Aged, Multivariate Analysis, Renal Agents / therapeutic use, Research Support, U.S. Gov't, P.H.S., Resuscitation, Retrospective Studies, Steroids / *therapeutic use, Thyroxine / therapeutic use, Tissue and Organ Procurement / *statistics & numerical data, Tissue Donors / *statistics & numerical data, Triiodothyronine / therapeutic use, Vasopressins / therapeutic use

BACKGROUND: Brain death results in adverse pathophysiologic effects in many cadaveric donors, resulting in cardiovascular instability and poor organ perfusion. Hormonal resuscitation (HR) has been reported to stabilize and improve cardiac function in brain-dead donors. The goal of this study was to examine the effect of HR on the brain-dead donor on the number of organs transplanted per donor. METHODS: A retrospective analysis of all brain-dead donors recovered in the United States from January 1, 2000, to September 30, 2001, was conducted. HR consisted of a methylprednisolone bolus and infusions of vasopressin and either triiodothyronine or L-thyroxine. Univariate analyses and multivariate logistic regression analyses were used to detect differences between the HR group and those donors who did not receive HR. RESULTS: Of 10,292 consecutive brain-dead donors analyzed, 701 received three-drug HR. Univariate analysis showed the mean number of organs from HR donors (3.8) was 22.5% greater than that from nonhormonal resuscitation donors (3.1) (P

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