OUTCOME FOLLOWING ORGAN REMOVAL FROM POISONED DONORS - EXPERIENCE WITH 12 CASES AND A REVIEW OF THE LITERATURE

Citation
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
Citations number
NO
Categorie Soggetti
Surgery,Transplantation
Journal title
ISSN journal
09340874
Volume
8
Issue
3
Year of publication
1995
Pages
185 - 189
Database
ISI
SICI code
0934-0874(1995)8:3<185:OFORFP>2.0.ZU;2-N
Abstract
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.