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Successful organ transplantation after treatment of fatal cyanide poisoning with hydroxocobalamin.

AbstractBACKGROUND:
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.
AuthorsJ L Fortin, M Ruttimann, G Capellier, A Bigorie, S Ferlicot, E Thervet
JournalClinical toxicology (Philadelphia, Pa.) (Clin Toxicol (Phila)) 2007 Jun-Aug Vol. 45 Issue 5 Pg. 468-71 ISSN: 1556-3650 [Print] England
PMID17503248 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Antidotes
  • Cyanides
  • Hydroxocobalamin
Topics
  • Antidotes (therapeutic use)
  • Cyanides (blood, poisoning)
  • Female
  • Heart Arrest (drug therapy)
  • Heart Transplantation
  • Humans
  • Hydroxocobalamin (therapeutic use)
  • Kidney Transplantation
  • Liver Transplantation
  • Male
  • Middle Aged
  • Tissue Donors

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