Anaphylaxis on reperfusion during liver transplantation with coagulopathy.
We present a case in which anaphylaxis on hepatic reperfusion during liver transplantation presented only with hypotension and coagulopathy. There were no cutaneous manifestations or clinical features distinguishing anaphylaxis from postreperfusion syndrome. The recipient regularly consumed seafood, and the organ donor died of anaphylaxis to shellfish. The trigger for anaphylaxis was postulated to be passive transfer of immunoglobulin to the recipient. Anesthesiologists should be notified of donor factors to anticipate anaphylaxis. In this report, we discuss coagulopathy of anaphylaxis and contrast it with disseminated intravascular coagulation.
Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI 53226, USA. hwoehlck@mcw.edu
Harvey J
HJ
Woehlck
Christopher P
CP
Johnson
Allan M
AM
Roza
Jerome L
JL
Gottschall
Melanie
M
Brumwell
David C
DC
Cronin
D000328:Adult; D000707:Anaphylaxis / Q000209:etiology*; D001778:Blood Coagulation Disorders / Q000209:etiology*; D006801:Humans; D008099:Liver / Q000098:blood supply*; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D015424:Reperfusion; D053802:Tryptases / Q000502:physiology
D053802:Tryptases