Successful organ transplantation after treatment of fatal cyanide poisoning with hydroxocobalamin

Background. Cyanide-poisoned patients are potential organ donors provided that organs are not damaged by the poison or by antidotal treatment. Case study. A patient with third-degree burns and smoke inhalation-associated cyanide poisoning confirmed by measurements of whole blood cyanide was found in...

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Bibliographic Details
Published inClinical Toxicology Vol. 45; no. 5; pp. 468 - 471
Main Authors Fortin, J.L., Ruttimann, M., Capellier, G., Bigorie, A., Ferlicot, S., Thervet, E.
Format Report
LanguageEnglish
Published Taylor & Francis 01.01.2007
Subjects
Cyanide poisoning
Hydroxocobalamin
Organ
Transplantation
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Summary:Background. Cyanide-poisoned patients are potential organ donors provided that organs are not damaged by the poison or by antidotal treatment. Case study. A patient with third-degree burns and smoke inhalation-associated cyanide poisoning confirmed by measurements of whole blood cyanide was found in cardiac arrest and administered epinephrine and hydroxocobalamin (5 g + 5 g). Cardiac activity resumed, but the patient was declared brain dead on the third day of hospitalization when coma deteriorated to a shock state with refractory hypoxemia. Kidneys, heart, and liver were removed and transplanted into four patients. Gross pre-transplantation inspection of the donor organs and renal histology showed no evidence that hydroxocobalamin caused organ toxicity. Donor organs functioned normally through follow-up periods of several months. Conclusion. Anoxic cardiac arrest following acute cyanide poisoning treated with hydroxocobalamin (5 g + 5 g) was not a contraindication to organ transplantation after confirmed encephalic death in this patient.
ISSN:1556-3650
1556-9519
DOI:10.1080/15563650701338179