Terlipressin as rescue therapy in catecholamine-resistant hypotension in solid organ donors: a case report.
OBJECTIVE
The objective of this study was to report the effects of Terlipressin treatment in 2 potential organ donors with intractable, catecholamine-resistant hypotension.


METHODS
This study was based on case reports in the intensive care unit of a general hospital.


METHODS
Patients included 2 adult patients with cerebral death and catecholamine-resistant hypotension.


METHODS
A low dose of Terlipressin (3.5 microg/kg) by intravenous bolus was added to the standard treatment.


RESULTS
In both cases, Terlipressin induced a rapid improvement in arterial pressure with a consequent increase in urine output and the appearance of diabetes insipidus. In 1 patient it allowed for the withdrawal of norepinephrine infusion. No related adverse effects were detected in either patient. Organ removal was not possible in the second case due to lack of family consent.


CONCLUSIONS
Terlipressin might be considered as a rescue therapy for potential organ donors with intractable, catecholamine-resistant hypotension. In spite of the positive results obtained here and by other authors in the treatment of septic shock, its judicious use is recommended, and an optimal administration schedule must still be elucidated.
Vecchiarelli
P
P
Intensive Care Unit, Belcolle Hospital, Viterbo, Italy. p.vecchiarelli@asl.vt.it
Ricci
F
F
Riccini
T
T
D000328:Adult; D000368:Aged; D001002:Anuria; D001794:Blood Pressure / Q000187:drug effects; D001926:Brain Death; D002543:Cerebral Hemorrhage; D004231:Diuresis / Q000187:drug effects; D006498:Hepatectomy; D006801:Humans; D007022:Hypotension / Q000188:drug therapy*; D016030:Kidney Transplantation / Q000502:physiology; D016031:Liver Transplantation / Q000502:physiology; D008236:Lypressin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D009392:Nephrectomy; D000077585:Terlipressin; D014019:Tissue Donors; D014662:Vasoconstrictor Agents / Q000627:therapeutic use*
D014662:Vasoconstrictor Agents; D008236:Lypressin; D000077585:Terlipressin