Effect of desmopressin substitution during organ procurement on early renal allograft function.
BACKGROUND
As diabetes insipidus in brain-dead organ donors leads to hypovolaemia, hyponatraemia, and hypotension, desmopressin is recommended for treatment of diabetes insipidus. As its effect on early renal allograft function remains unclear, we conducted a study to evaluate the effect of desmopressin on renal-graft survival.


METHODS
We report the results of a prospective study in 41 brain-dead organ donors (mean age 45 +/- 12 years) with diabetes insipidus, who were treated either with adequate fluid substitution and bolus application of desmopressin (desmopressin group; n = 22) or with volume substitution along (control group; n = 19). Donors as well as recipients of both groups were well matched with respect to age, sex, dopamine dosage, serum electrolytes, cold ischaemic time, HLA match, number of prior transplantations, and current cytotoxic antibodies. Early renal allograft function was evaluated in 71 recipients (mean age 48 +/- 4 years within 3 days after transplantation.


RESULTS
Overall, primary non-function was observed in 26 (36.6%) of 71 recipients. The rate of primary non-function was significantly higher in the desmopressin group compared to the control group (desmopressin group 48.6%; control group 23.5%; P = 0.28).


CONCLUSIONS
The use of desmopressin during organ procurement is associated with a higher rate of primary non-function of renal allografts.
Hirschl
M M
MM
Department of Emergency Medicine, New General Hospital, University of Vienna.
Matzner
M P
MP
Huber
W O
WO
Binder
W O
WO
Röggla
G
G
Derfler
K
K
Mühlbacher
F
F
Laggner
A N
AN
D000293:Adolescent; D000328:Adult; D000368:Aged; D001926:Brain Death / Q000503:physiopathology; D002648:Child; D003404:Creatinine / Q000378:metabolism; D003894:Deamino Arginine Vasopressin / Q000494:pharmacology*; D003919:Diabetes Insipidus / Q000188:drug therapy; D005260:Female; D006085:Graft Survival / Q000187:drug effects*; D006801:Humans; D016030:Kidney Transplantation / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012076:Renal Agents / Q000494:pharmacology*; D009927:Tissue and Organ Procurement; D014184:Transplantation, Homologous
D012076:Renal Agents; D003404:Creatinine; D003894:Deamino Arginine Vasopressin