Organ Donors Clinical Trial
Official title:
Effects of Terlipressin on Management of Potential Organ Donors:a Retrospective Study
During brain death, many significant systemic changes take place and among these, the most
notable is hemodynamic instability.
In the pathogenesis of brain death, after the hypertensive phase of the "catecholamine
storm", arterial tonus and heart inotropism eventually deteriorate, leading to hypotension
and hypoperfusion. Therefore, vasopressor agents are necessary in treatment of brain-dead
organ donors. The most commonly used and recommended vasoactive drugs for this indication are
dopamine, norepinephrine, and vasopressin.The Transplantation Committee of the American
College of Cardiology recommends vasopressin as the primary vasoactive drug for treating
hemodynamic instability and diabetes insipidus in brain-death heart donors.
Terlipressin (TP) is a new type of synthetic long-acting vasopressin preparations, AVP
long-acting derivatives, belongs to a kind of precursor drugs, itself is inactive, the body
through the aminopeptidase, slow "release" of a reactive lysine vasopressin. On the one
hand,terlipressin can splanchnic vascular smooth muscle contraction, reduces splanchnic blood
flow (e.g., reduce blood flow to the mesenteric, spleen, uterus, etc), to ensure the flow of
blood to the important viscera;On the other hand, it reduces the concentration of plasma
renin, increases the perfusion of renal blood flow, and improves the glomerular filtration
rate, thus improving renal function.From the pharmacological perspective, it is better than
arginine vasopressin for the stability of hemodynamics and the perfusion of tissue.
Whether or not it has therapeutic effect on the potential brain death donor with unstable
hemodynamics is not studied in the literature at home and abroad.This paper discusses the
application value of terlipressin in the management of potential brain death, and provides
clinical evidence for the maintenance of brain death donor.
Thermodilution cardiac output was measured in triplicate. Hemodynamic parameters were calculated according to standard formulas.Oxygen delivery index (IDO2) was calculated as arterial oxygen content multiplied by CI. Systemic vascular resistance index (SVRI) was calculated as the MAP minus right atrial pressure divided by CI and multiplied by 80. Pulmonary vascular resistance index (PVRI) was calculated as the mean pulmonary artery pressure (PAP) minus pulmonary artery occlusion pressure divided by CI. Left and right ventricular stroke work index (L and RVSWI) were calculated .The following laboratory parameters were collected: bilirubin, aspartate aminotransferase (AST), alanine aminotransferase (ALT),prothrombin time, and thrombocytes. ;
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