title: Arginine vasopressin significantly increases the rate of successful organ procurement in potential donors.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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).
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Division of Trauma, Acute Care Surgery and Surgical Critical Care, Harbor-UCLA Medical Center, Torrance, CA, USA. dplurad@dhs.lacounty.gov
authors.forename: David S
authors.initials: DS
authors.lastname: Plurad
authors.forename: Scott
authors.initials: S
authors.lastname: Bricker
authors.forename: Angela
authors.initials: A
authors.lastname: Neville
authors.forename: Frederic
authors.initials: F
authors.lastname: Bongard
authors.forename: Brant
authors.initials: B
authors.lastname: Putnam
mesh_terms: D000328:Adult; D001127:Arginine Vasopressin / Q000008:administration & dosage*; D001926:Brain Death; D016208:Databases, Factual; D005260:Female; D020249:Hormone Replacement Therapy / Q000379:methods*; D006801:Humans; D007263:Infusions, Parenteral; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012151:Resuscitation / Q000379:methods*; D014019:Tissue Donors; D020858:Tissue and Organ Harvesting / Q000379:methods* / Q000706:statistics & numerical data; D009927:Tissue and Organ Procurement; D014662:Vasoconstrictor Agents / Q000008:administration & dosage*
chemical_list: D014662:Vasoconstrictor Agents; D001127:Arginine Vasopressin