title: Anti-thymocyte globulin induced non-cardiogenic pulmonary edema during renal transplantation.
abstract: Non-cardiogenic pulmonary edema (NCPE) is a clinical syndrome characterized by simultaneous presence of severe hypoxemia, bilateral alveolar infiltrates on chest radiograph, without evidence of left atrial hypertension/congestive heart failure/fluid overload. The diagnosis of drugrelated NCPE relies upon documented exclusion of other causes of NCPE like gastric aspiration, sepsis, trauma, negative pressure pulmonary edema. We describe a 28year-old, 50 kg male with ASA risk III posted for laparoscopic renal transplantation, who developed NCPE after 4 hours of administration of rabbit anti-human thymocyte immunoglobulin (ATG). He was successfully treated with mechanical ventilatory support and adjuvant therapy. This report emphasizes that this fatal complication may occur with use of ATG.
authors.affiliation: Department of Anaesthesia and Critical Care, Institute of Kidney Diseases and Research Centre and Institute of Transplantation Sciences, Civil Hospital Campus, Ahmedabad - 380 016, Gujarat, India.
authors.forename: Beena K
authors.initials: BK
authors.lastname: Parikh
authors.forename: Guruprasad P
authors.initials: GP
authors.lastname: Bhosale
authors.forename: Veena R
authors.initials: VR
authors.lastname: Shah