Background: 40-80% of brain-dead potential organ donors develop a central d
iabetes insipidus (CDI). Desmopressin (dDAVP) is conventionally used in int
ensive care units to prevent hypovolemia, hyponatriemia and hypotension.
Aim of this study was to evaluate the effects of desmopressin on microcircu
lation in donor organs and early allograft function after pancreas transpla
Methods: 30 male Brattleboo rats with hereditary CDI served as model of the
organ donor. An evaluation of microcirculatory parameters was performed in
organ donor model and 1 h and 6 h after reperfusion after autologous pancr
Results: In organ donor groups those pretreated with i.v. desmopressin show
ed increased rolling (1694 +/- 351/mm(2)) and a reduced capillary erythrocy
te velocity (0.34 +/- 0.11 mm/s) compared to controls (491 +/- 227/mm(2) or
0.91 +/- 0.11 mm/s) 60 min after application. After transplantation pretre
ated donors showed reduced erythrocyte blood flow velocities as well as inc
reased rolling and sticking (p < 0.05).
Conclusion: Desmopressin in repeated application and application in the mod
el of organ donor with CDI one hour before explantation leads to impairment
of microcirculation and increased leucocyte endothelial interaction in don
or and 6 h after reperfusion. The effects of desmopressin can be expained b
y increased vasoconstriction, p-selectin liberation out of weibel palade bo
dies and activation of thrombocytes. 60 min before organ explantation indic
ation for application of desmopressin has to be questioned.