EFFECT OF DESMOPRESSIN SUBSTITUTION DURING ORGAN PROCUREMENT ON EARLYRENAL-ALLOGRAFT FUNCTION

Background. As diabetes insipidus in brain-dead organ donors leads to hypovolaemia, hyponatraemia, and hypotension, desmopressin is recommen ded for treatment of diabetes insipidus. As its effect on early renal allograft function remains unclear, we conducted a study to evaluate t he effect of desmopressin on renal-graft survival. Methods. We report the results of a prospective study in 41 brain-dead organ donors (mean age 45+/-12 years) with diabetes insipidus, who were treated either w ith adequate fluid substitution and bolus application of desmopressin (desmopressin group; n=22) or with volume substitution alone (control group; n=19). Donors as well as recipients of both groups were well ma tched with respect to age, sex, dopamine dosage, serum electrolytes, c old ischaemic time, HLA match, number of prior transplantations, and c urrent cytotoxic antibodies, Early renal allograft function was evalua ted in 71 recipients (mean age 48+/-14 years) within 3 days after tran splantation. Results. Overall, primary non-function was observed in 26 (36.6%) of 71 recipients. The rate of primary non-function was signif icantly higher in the desmopressin group compared to the control group (desmopressin group 48.6%; control group 23.5%; P=0.028). Conclusion. The use of desmopressin during organ procurement is associated with a higher rate of primary non-function of renal allografts.