The role of hormone replacement therapy in the intensive care management of deceased organ donors: a primer for nurses.
Donation after brain death remains the primary contributor to the supply of organs available for transplantation in the United States. After brain death, both a surge of catecholamines and a dysregulation of the neurohormonal axis may result in hypotension, decreased organ perfusion, and reduced viability of organs to be transplanted. Hormone replacement therapy is widely used to maintain organ perfusion and has been shown to increase the number of organs procured. This article reviews the literature and mechanisms supporting the use of hormone replacement therapy in brain-dead organ donors and provides clinicians with information regarding the administration, monitoring, and preparation of thyroid hormone, arginine vasopressin, and corticosteroids.
University of Kentucky Healthcare (Dr Smetana), Lexington, Kentucky; and Methodist Healthcare-University Hospital and University of Tennessee Health Sciences Center (Drs Kimmons and Jones), Memphis, Tennessee.
Keaton S
KS
Smetana
Lauren A
LA
Kimmons
G Morgan
GM
Jones
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D001926:Brain Death; D003422:Critical Care; D004359:Drug Therapy, Combination; D020249:Hormone Replacement Therapy / Q000379:methods*; D006801:Humans; D009741:Nursing Staff, Hospital / Q000193:education*; D010477:Perfusion; D013963:Thyroid Hormones / Q000627:therapeutic use; D014019:Tissue Donors; D014481:United States; D014662:Vasoconstrictor Agents / Q000627:therapeutic use
D000305:Adrenal Cortex Hormones; D013963:Thyroid Hormones; D014662:Vasoconstrictor Agents