Hemodynamic Follow-Up of Cardiac Allografts From Poisoned Donors

Abstract

Based on our limited experience, cardiac allografts from donors exposed to different kinds of poisons can be transplanted in selected cases. If the donor organ is not hemodynamically compromised, showing regular filling pressures on low or mild inotropic support just before explantation, and if there are no electrocardiographic changes in combination with elevation of the transaminases, cardiac allograft transplantation seems to be a safe and life-saving procedure.

Successful use of a cardiac allograft from tricyclic antidepressant intoxication

“…In the study by Abramowicz et al (2), 30 of 85 patients (35%) in the withdrawal group had experienced a rejection episode as opposed to 1 of 32 (3%) in the present study (1). Moreover, the subjects were rejection free for 6 months in the present study compared with only 3 months in the previous study.…”

Extended criteria for organ acceptance. Strategies for achieving organ safety and for increasing organ pool

“…Transplantation of organs obtained from patients who die from intoxication with acetaminophen, amanita phalloides, barbiturates, benzodiazepines, butane, carbon monoxide, cocaine, cyanide, ecstasy, ethanol, ethylene glycol, isoniazid, lead, lithium, methanol, organophosphate, rodenticides (brodifacoum), thioridazine, trichloroethylene and tricyclic antidepressants has been performed without transmitting intoxication to recipients and without adding additional complications to the recipients compared with organs from non-intoxicated donors (57,(168)(169)(170)(171)(172)(173)(174)(175)(176)(177), and without different short and long-term graft and patient actuarial survival compared with organs from non-intoxicated donors (57,172,176,177). Thoracic and abdominal organs have been successfully transplanted from donors who were chronic consumers of ethanol or inhaled cocaine or marijuana, without affecting immediate and late graft function or short and long-term graft and patient survival (57,169,178,179).…”

Short‐ and long‐term success of organs transplanted from acute methanol poisoned donors

“…The shortage of organs for transplantation and the high level of potential recipients who die while on the waiting list because of the unavailability of grafts has made it possible to extend the classical criteria for the acceptance of organ donors, and among others those dying from intoxications from certain medicines, drugs and industrial and domestic products are accepted as donors (1–4). They may represent 1% of total organ donors and may involve 1.1% of the total organs transplanted (2).…”