Cyanide Poisoning Victims as Corneal Transplant Donors

Lindquist, Thomas D.; Oiland, Donna; Weber, Kurt

doi:10.1016/s0002-9394(14)76632-2

Cited by 13 publications

(2 citation statements)

References 3 publications

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“…In 1988, Lindquist et al 1 first claimed that victims of cyanide poisoning might serve as suitable corneal donors. Ravishankar et al 2 also presented a case of cyanide poisoning in 1998, in which the kidneys and corneas were harvested after the level of poison fell to below lethal concentration.…”

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confidence: 99%

Suicide victim of paraquat poisoning make suitable corneal donor

et al. 2010

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This report addresses the possibility of expanding transplant corneal donor pool by inclusion of more patients who have suffered poisoning with paraquat pre-mortem. A 27-year-old depressed man committed suicide by ingesting 50 mL of 24% paraquat (Gramoxone, Syngenta, Taiwan). He was treated aggressively with gastric lavage, with large amounts of normal saline, followed by infusion of activated charcoal and magnesium citrate. Blood paraquat level was 1.90 μg/mL. Charcoal hemoperfusion was performed for 8 hours using a charcoal-containing dialysis machine. Furthermore, pulse therapies of cyclophosphamide (15 mg/kg/day for 2 days) and methylprednisolone (1 g/day for 3 days) were administered, followed by dexamethasone (20 mg/day for 14 days). Methylprednisolone pulse therapy was repeated since PaO2 on the 15th day of poisoning was <60 mm Hg. Chest radiography demonstrated diffuse ground glass opacities of both lungs, with thickening of the intralobular interstitium, compatible with interstitial pneumonitis. Arterial blood gas found persistent hypoxemia and large alveolar-arterial oxygen tension differences. Respiratory failure developed on the 21st day and he was intubated for mechanical ventilatory support. As the patient expressed his wish for organ donation, the corneas were harvested after expiration on the 22nd day. His corneas were transplanted in two recipients and visual acuities of the recipients were doing well at 6 months after transplantation.

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Section: Introductionmentioning

confidence: 99%

Suicide victim of paraquat poisoning make suitable corneal donor

et al. 2010

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“…Although some tissue injuries associated with toxins such as acetaminophen will limit liver transplantation due to hepatotoxicity, most other organs in the same individual can be subsequently utilized [8]. Other examples such as carbon monoxide [9][10][11][12] or cyanide [13][14][15][16][17] poisoning may lead to transplantation of many organs following death. There are many available examples of detailed reviews on the subject of successful organ donation of corneas, hearts, kidneys, livers, lungs, pancreas, and skin following lethal poisoning from a broad spectrum of xenobiotics [18][19][20][21][22].…”

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The Role of the Medical Toxicologist in Organ Transplantation

2012

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Outcome following organ removal from poisoned donors: experience with 12 cases and a review of the literature

et al. 1995

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From 1975 to 1993, our University Hospital performed 2789 graft procedures. During the same period, 12 poisoned, "brain-dead" patients were considered as organ donors. The toxic substances involved were: methaqualone (n = 1), benzodiazepine alone (n = 1), benzodiazepine plus tricyclic antidepressants (n =1), tricyclic antidepressants alone (n = 1), barbiturates (n = 2), insulin (n = 2), carbon monoxide (n = 1), cyanide (n = 1), methanol (n = 1), and acetaminophen (n = 1). From these intoxicated persons, 32 organ transplants were obtained, but only 23 could be followed for 1 month and only 20 for 1 year. The outcome at 1 month was favorable in 20 of the 23 patients. Two heart transplant patients died with 24h after grafting from stroke and acute heart failure, respectively. Preoperative hepatic encephalopathy was not corrected after grafting and was directly responsible for the death of a liver transplant patient. After 1 year, 15 of the 20 recipients were still alive. Chronic hepatic graft rejection led to a fatal outcome in one recipient and to second grafting in another. Finally, one recipient died from delayed neoplasia. Based on our experience, organ procurement may be considered in a few select cases of acute poisoning. Attention should, however, be drawn to possible graft damage due to some poisons.

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Cyanide Poisoning Victims as Corneal Transplant Donors

Cited by 13 publications

References 3 publications

Suicide victim of paraquat poisoning make suitable corneal donor

Suicide victim of paraquat poisoning make suitable corneal donor

The Role of the Medical Toxicologist in Organ Transplantation

Outcome following organ removal from poisoned donors: experience with 12 cases and a review of the literature

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