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Extracorporeal Life Support in a Case of Fatal Flecainide and Betaxolol Poisoning Allowing Successful Cardiac Allograft

2010; Elsevier BV; Volume: 56; Issue: 4 Linguagem: Inglês

10.1016/j.annemergmed.2010.01.021

1097-6760

Benoît Vivien, Nicolas Deye, Bruno Mégarbane, Jean-Sébastien Marx, Pascal Leprince, Nicolas Bonnet, France Roussin, Laurent Jacob, Alain Pavie, Frédéric J. Baud, Pierre Carli,

Cardiac Arrest and Resuscitation

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. 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.