{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T09:59:31Z","timestamp":1784368771375,"version":"3.55.0"},"reference-count":19,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2024,11,22]],"date-time":"2024-11-22T00:00:00Z","timestamp":1732233600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Open Access Publishing Fund of Leipzig University"},{"name":"German Research Foundation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Arginine vasopressin deficiency (AVP-D) is a common condition in the setting of brain death. The aim of this study was to analyze the frequency of AVP-D in organ donors, its treatment, as well as the impact of AVP-D on hemodynamics and renal function. Methods: This single-center, retrospective study included 63 organ donors treated between 2017 and 2022. We used standard criteria to examine the incidence of AVP-D and the KDIGO criteria to determine the rate of acute kidney injury (AKI). Results: AVP-D occurred in 79% of the examined organ donors, of which 94% received desmopressin. Overall, 30% of organ donors developed AKI. AKI was present in 77% of donors who did not meet AVP-D criteria and in only 18% of donors with AVP-D (p &lt; 0.001). Mean arterial blood pressure did not differ between organ donors with and without AVP-D or with and without desmopressin therapy. In organ donors with AVP-D, norepinephrine requirement in the period 24 h prior to AVP-D diagnosis was lower than 24 h afterwards (p = 0.03). AVP-D diagnosis was associated with a higher rate of kidney transplantation compared to cases without AVP-D diagnosis (88% vs. 54%, p = 0.01). Conclusions: AVP-D is common among brain death organ donors and may remain undiagnosed in cases with previous kidney injury. These observations highlight the importance of recognizing AVP-D and administering appropriate therapy in potential organ donors to prevent AKI.<\/jats:p>","DOI":"10.3390\/jcm13237073","type":"journal-article","created":{"date-parts":[[2024,11,22]],"date-time":"2024-11-22T12:07:32Z","timestamp":1732277252000},"page":"7073","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Incidence and Treatment of Arginine Vasopressin Deficiency (Central Diabetes Insipidus) in the Setting of Brain Death and Associations with Renal Function and Hemodynamics in Organ Donors"],"prefix":"10.3390","volume":"13","author":[{"given":"Marleen","family":"Wei\u00df","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Medicine, Medical Faculty, Leipzig University, University of Leipzig Medical Center, 04103 Leipzig, Germany"},{"name":"Department of Anesthesiology and Intensive Care Medicine, Medical Faculty, University of Magdeburg, 39120 Magdeburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabian","family":"R\u00fccker","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Medicine, Medical Faculty, Leipzig University, University of Leipzig Medical Center, 04103 Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Volker","family":"Thieme","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Medicine, Medical Faculty, Leipzig University, University of Leipzig Medical Center, 04103 Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karsten","family":"Hochmuth","sequence":"additional","affiliation":[{"name":"German Organ Procurement Organization (DSO), Region East, 04157 Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominik","family":"Michalski","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Leipzig Medical Center, 04103 Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7587-9935","authenticated-orcid":false,"given":"Bj\u00f6rn","family":"Nashan","sequence":"additional","affiliation":[{"name":"Department of Organ Transplantation Center, The First Affiliated Hospital of University of Science and Technology of China, Hefei 230001, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans-Michael","family":"Tautenhahn","sequence":"additional","affiliation":[{"name":"Department of Visceral, Transplantation, Thoracic and Vascular Surgery, University of Leipzig Medical Center, 04103 Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1176-161X","authenticated-orcid":false,"given":"Robert","family":"Werdehausen","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Medicine, Medical Faculty, University of Magdeburg, 39120 Magdeburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8886-2064","authenticated-orcid":false,"given":"Svitlana","family":"Ziganshyna","sequence":"additional","affiliation":[{"name":"Organ Donation Coordinator Unit, Medical Faculty, Leipzig University, University of Leipzig Medical Center, 04103 Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,11,22]]},"reference":[{"key":"ref_1","unstructured":"(2024, February 13). Eurotransplant\u2014Statistics. Available online: https:\/\/statistics.eurotransplant.org\/."},{"key":"ref_2","first-page":"243","article-title":"Management of the Brain-Dead, Heart-Beating Potential Donor","volume":"4","author":"Cohen","year":"2002","journal-title":"Isr. Med. Assoc. J."},{"key":"ref_3","unstructured":"Hui, C., Khan, M., Khan Suheb, M.Z., and Radbel, J.M. (2024). Arginine Vasopressin Disorder (Diabetes Insipidus). StatPearls, StatPearls Publishing."},{"key":"ref_4","first-page":"125","article-title":"Management to Optimize Organ Procurement in Brain Dead Donors","volume":"75","author":"Mascia","year":"2009","journal-title":"Minerva Anestesiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1007\/s00134-019-05551-y","article-title":"Management of the Brain-Dead Donor in the ICU: General and Specific Therapy to Improve Transplantable Organ Quality","volume":"45","author":"Meyfroidt","year":"2019","journal-title":"Intensive Care Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1007\/s12055-021-01224-y","article-title":"Management of the Brain-Dead Organ Donor","volume":"37","author":"Clarke","year":"2021","journal-title":"Indian. J. Thorac. Cardiovasc. Surg."},{"key":"ref_7","first-page":"552","article-title":"Organ-Protective Intensive Care in Organ Donors","volume":"113","author":"Hahnenkamp","year":"2016","journal-title":"Dtsch. Arztebl. Int."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1177\/000313480607200502","article-title":"Complications of Brain Death: Frequency and Impact on Organ Retrieval","volume":"72","author":"Salim","year":"2006","journal-title":"Am. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1097\/00007890-199211000-00016","article-title":"Acute endocrine failure after brain death?","volume":"54","author":"Gramm","year":"1992","journal-title":"Transplantation"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"12","DOI":"10.2478\/jccm-2018-0005","article-title":"Brain Death in Children: Incidence, Donation Rates, and the Occurrence of Central Diabetes Insipidus","volume":"4","author":"Yener","year":"2018","journal-title":"J. Crit. Care Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1252","DOI":"10.1097\/TP.0b013e318236cd4c","article-title":"Donor Desmopressin Is Associated with Superior Graft Survival After Kidney Transplantation","volume":"92","author":"Benck","year":"2011","journal-title":"Transplantation"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1007\/s11560-013-0752-1","article-title":"KDIGO-Leitlinien zum akuten Nierenversagen","volume":"8","author":"Bienholz","year":"2013","journal-title":"Nephrologe"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1016\/j.jss.2013.09.028","article-title":"The Effect of Arginine Vasopressin on Organ Donor Procurement and Lung Function","volume":"186","author":"Callahan","year":"2014","journal-title":"J. Surg. Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1178","DOI":"10.1016\/S0140-6736(98)05456-7","article-title":"Administration of Desmopressin in Brain-Dead Donors and Renal Function in Kidney Recipients","volume":"352","author":"Guesde","year":"1998","journal-title":"Lancet"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"978","DOI":"10.1097\/01.TP.0000135565.49535.60","article-title":"Effect of Brain Death on Gene Expression and Tissue Activation in Human Donor Kidneys","volume":"78","author":"Nijboer","year":"2004","journal-title":"Transplantation"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e58","DOI":"10.1097\/CCM.0000000000006131","article-title":"The Relationship Between Manifestation of Diabetes Insipidus and Estimated Glomerular Filtration Rate in Brain Death","volume":"52","author":"Varelas","year":"2024","journal-title":"Crit. Care Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1007\/s11154-023-09862-w","article-title":"New Insights on Diagnosis and Treatment of AVP Deficiency","volume":"25","author":"Refardt","year":"2024","journal-title":"Rev. Endocr. Metab. Disord."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"79","DOI":"10.5500\/wjt.v12.i4.79","article-title":"Can Adequate Hemodynamic Management of Brain-Dead Donors Improve Donor Organ Procurement?","volume":"12","author":"Thet","year":"2022","journal-title":"World J. Transplant."},{"key":"ref_19","unstructured":"(2024, February 06). Intensive Care Society of Ireland\u2014Guidelines for Management of the Potential Organ Donor (2018, 2nd Edition)|Irish Journal of Medical Science. Available online: https:\/\/link.springer.com\/article\/10.1007\/s11845-019-01987-9."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/23\/7073\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:37:52Z","timestamp":1760114272000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/23\/7073"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,22]]},"references-count":19,"journal-issue":{"issue":"23","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["jcm13237073"],"URL":"https:\/\/doi.org\/10.3390\/jcm13237073","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,22]]}}}