title: Anesthetic management of donor nephrectomy for a recipient with history of malignant hyperthermia: avoiding a transferred trigger.
abstract: We describe a case of living unrelated renal transplantation from a non-malignant hyperthermia (MH) susceptible donor to an MH-susceptible recipient, along with its intraoperative and perioperative considerations. The renal transplant recipient reported a personal history of MH requiring intensive care unit admission. A nontriggering anesthetic was therefore chosen for the unrelated donor to avoid possible triggering via the transplanted kidney to the MH-susceptible recipient. This case provides a unique opportunity to review the concepts of antigen transfer related to transplant anesthesia, as well as the importance of communication among anesthesia and surgical teams to promote patient safety.
authors.affiliation: Department of Anesthesiology, Columbia University Medical Center, New York, NY, USA. Electronic address: jes9152@nyp.org.
authors.forename: Jacob
authors.initials: J
authors.lastname: Schaff
authors.affiliation: Department of Anesthesiology, Columbia University Medical Center, New York, NY, USA. Electronic address: rm3046@cumc.columbia.edu.
authors.forename: Robert
authors.initials: R
authors.lastname: Maniker
mesh_terms: D000732:Androstanols; D018686:Anesthetics, Intravenous; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D019520:Living Donors; D008305:Malignant Hyperthermia / Q000150:complications / Q000517:prevention & control*; D008875:Middle Aged; D009392:Nephrectomy; D003473:Neuromuscular Nondepolarizing Agents; D061214:Patient Safety; D010880:Piperidines; D015742:Propofol; D000077208:Remifentanil; D000077123:Rocuronium; D020858:Tissue and Organ Harvesting
chemical_list: D000732:Androstanols; D018686:Anesthetics, Intravenous; D003473:Neuromuscular Nondepolarizing Agents; D010880:Piperidines; D000077208:Remifentanil; D000077123:Rocuronium; D015742:Propofol
keywords: Anaphylaxis; Antigen transfer; Malignant hyperthermia; Patient safety; Transplantation