Extracorporeal life support in a case of fatal flecainide and betaxolol poisoning allowing successful cardiac allograft.
Use of cardiac allograft for transplantation from donors after acute poisoning is a matter of debate because of potential toxic organ injuries, especially if death results from massive ingestion of cardiotoxic drugs. We report successful allograft cardiac transplantation from a brain-dead patient after severe flecainide and betaxolol self-poisoning requiring extracorporeal life support. Extracorporeal life support was initiated in the emergency department because of a refractory cardiac arrest caused by the cardiotoxicants' ingestion and continued after the onset of brain death to facilitate organ donation of the heart, liver, and kidneys. Forty-five months later, each organ recipient was alive, with normal graft function.
Vivien
Benoît
B
Département d'Anesthésie-Réanimation, Hôpital Necker Enfants Malades, Paris, France. benoit.vivien@nck.aphp.fr
Deye
Nicolas
N
Mégarbane
Bruno
B
Marx
Jean-Sébastien
JS
Leprince
Pascal
P
Bonnet
Nicolas
N
Roussin
France
F
Jacob
Laurent
L
Pavie
Alain
A
Baud
Frédéric J
FJ
Carli
Pierre
P
D000328:Adult; D000889:Anti-Arrhythmia Agents / Q000506:poisoning*; D000959:Antihypertensive Agents / Q000506:poisoning*; D015784:Betaxolol / Q000506:poisoning*; D001926:Brain Death / Q000175:diagnosis; D004562:Electrocardiography; D005112:Extracorporeal Circulation; D005260:Female; D005424:Flecainide / Q000506:poisoning*; D006321:Heart / Q000187:drug effects / Q000503:physiopathology; D016027:Heart Transplantation; D006801:Humans; D009927:Tissue and Organ Procurement
D000889:Anti-Arrhythmia Agents; D000959:Antihypertensive Agents; D005424:Flecainide; D015784:Betaxolol