Terlipressin as rescue therapy in catecholamine-resistant hypotension in solid organ donors: a case report

Abstract

Objective: The objective of this study was to report the effects of Terlipressin treatment in 2 potential organ donors with intractable, catecholamine-resistant hypotension.

Design and setting: This study was based on case reports in the intensive care unit of a general hospital.

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

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

Measurement and 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.