P. Hantson et al., OUTCOME FOLLOWING ORGAN REMOVAL FROM POISONED DONORS - EXPERIENCE WITH 12 CASES AND A REVIEW OF THE LITERATURE, Transplant international, 8(3), 1995, pp. 185-189
From 1975 to 1993, our University Hospital performed 2789 graft proced
ures. During the same period, 12 poisoned, ''brain-dead'' patients wer
e considered as organ donors. The toxic substances involved were: meth
aqualone (n = 1), benzodiazepine alone (n = 1), benzodiazepine plus tr
icyclic antidepressants (n = 1), tricyclic antidepressants alone (n =
1), barbiturates (n = 2), insulin (n = 2), carbon mon oxide (n = 1), c
yanide (n = 1), methanol (n = 1), and acetaminophen (n = 1). From thes
e intoxicated persons, 32 organ transplants were obtained, but only 23
could be followed for 1 month and only 20 for 1 pear, The outcome at
1 month was favorable in 20 of the 23 patients. Two heart transplant p
atients died within 24 h after grafting from stroke and acute heart fa
ilure, respectively. Preoperative hepatic encephalopathy was not corre
cted after grafting and was directly responsible for the death of a li
ver transplant patient. After 1 year, 15 of the 20 recipients were sti
ll alive. Chronic hepatic graft rejection led to a fatal outcome in on
e recipient and to second grafting in another. Finally, one recipient
died from delayed neoplasia. Based on our experience, organ procuremen
t may be considered in a few select cases of acute poisoning. Attentio
n should, however, be drawn to possible graft damage due to some poiso
ns.