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Aggressive pharmacologic donor management results in more transplanted organs.
- Source :
-
Transplantation [Transplantation] 2003 Feb 27; Vol. 75 (4), pp. 482-7. - Publication Year :
- 2003
-
Abstract
- 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.<br />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.<br />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 <0.001). Multivariate analyses showed that HR was associated with the following statistically significant increased probabilities of an organ being transplanted from a donor: kidney 7.3%, heart 4.7%, liver 4.9%, lung 2.8%, and pancreas 6.0%. Extrapolation of these probabilities to the 5,921 brain-dead donors recovered in 2001 was calculated to yield a total increase of 2,053 organs.<br />Conclusion: HR stabilizes certain brain-dead donors and is associated with significant increases in organs transplanted per donor.
- Subjects :
- Adult
Child
Child, Preschool
Humans
Middle Aged
Multivariate Analysis
Renal Agents therapeutic use
Resuscitation
Retrospective Studies
Thyroxine therapeutic use
Triiodothyronine therapeutic use
Vasopressins therapeutic use
Brain Death
Steroids therapeutic use
Tissue Donors statistics & numerical data
Tissue and Organ Procurement statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 0041-1337
- Volume :
- 75
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Transplantation
- Publication Type :
- Academic Journal
- Accession number :
- 12605114
- Full Text :
- https://doi.org/10.1097/01.TP.0000045683.85282.93