• David S Plurad, Scott Bricker, Angela Neville, Frederic Bongard, and Brant Putnam.
• Division of Trauma, Acute Care Surgery and Surgical Critical Care, Harbor-UCLA Medical Center, Torrance, CA, USA. dplurad@dhs.lacounty.gov
• Am. J. Surg. 2012 Dec 1;204(6):856-60; discussion 860-1.

BackgroundHormone 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.MethodsThe 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).ResultsA 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.ConclusionsThe 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.Copyright © 2012 Elsevier Inc. All rights reserved.

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