Division of Trauma, Acute Care Surgery and Surgical Critical Care, Harbor-UCLA Medical Center, Torrance, CA, USA.
Am J Surg. 2012 Dec;204(6):856-60; discussion 860-1. doi: 10.1016/j.amjsurg.2012.05.011. Epub 2012 Oct 29.
Hormone replacement therapy increases the number and quality of grafts recovered from brain-dead organ donors. Arginine vasopressin (AVP) has also been shown to have beneficial effects. The aim of this study was to determine the effect of AVP on recovery rates.
The Organ Procurement and Transplantation Network database was used. Donors treated with hormone replacement therapy and vasopressor agents who were successfully procured between January 1, 2009, and June 30, 2011, were studied. AVP-positive and AVP-negative donors were compared. The primary study end point was the rate of high-yield procurement (≥4 organs).
A total of 10,431 donors were included. AVP was infused in 7,873 (75.5%) and was associated with an increased rate of high-yield procurement (50.5% vs 35.6%, P < .001). There was less overall graft refusal due to poor function (38.9% vs 45.6%, P < .001). AVP independently predicted high yield procurement.
The use of AVP with hormone replacement therapy is independently associated with an increased rate of organ recovery. This strategy should be universally adopted in the management of donors progressing to neurologic death.
激素替代疗法可增加脑死亡器官捐献者中采集到的移植物数量和质量。血管加压素（AVP）也已被证明具有有益的效果。本研究旨在确定 AVP 对回收率的影响。
使用器官获取和移植网络数据库。研究了 2009 年 1 月 1 日至 2011 年 6 月 30 日期间成功采集的接受激素替代疗法和血管加压素药物治疗的供者。比较了 AVP 阳性和 AVP 阴性供者。主要研究终点是高产量采集率（≥4 个器官）。
共纳入 10431 名供者。在 7873 名供者（75.5%）中输注了 AVP，高产量采集率（50.5%比 35.6%，P<0.001）增加。由于功能不良导致整体移植物拒绝率降低（38.9%比 45.6%，P<0.001）。AVP 独立预测了高产量采集。
AVP 与激素替代疗法联合使用与器官回收率的提高独立相关。这种策略应在管理进展为神经死亡的供者中普遍采用。
