Successful Renal Transplantation after Presumed Cyanide Toxicity Treated with Hydroxocobalamin and Review of the Literature
Authors
Hendrix, Ryan J.Martins, Paulo N.A.
Stoff, Jeffrey S.
Ahearn, Aaron
Bozorgzadeh, Adel
Movahedi, Babak
UMass Chan Affiliations
Department of Medicine, Division of NephrologyDepartment of Surgery, Division of Organ Transplantation
Document Type
Journal ArticlePublication Date
2018-09-09
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We report two cases of successful renal transplantation with allografts from donors who suffered anoxic brain injury as the primary cause of death from house fires. Each was treated prophylactically with hydroxocobalamin (Cyanokit) for suspected cyanide toxicity. During organ procurement, gross examination was notable for deep discoloration of the parenchymal tissues. Approximately 6 and 18 months after transplantation, both recipients have excellent renal graft function and remain independent from hemodialysis (HD). Hydroxocobalamin is the antidote for suspected acute cyanide toxicity. While largely tolerated by the recipient, there is concern over the potential functional implications of the associated side effects of dramatic tissue discoloration and development of oxalate crystals. Furthermore, difficulties performing hemodialysis in patients treated with hydroxocobalamin have been reported due to discoloration of the effluent fluid impacting the colorimetric sensor, causing false alarms and repetitive interruptions. As such, many transplant centers in the United States (US) continue to reject these organs. We seek to highlight two cases of successful transplantation following donor administration of hydroxocobalamin (Cyanokit) and present the first documented case of successful perioperative intermittent hemodialysis following transplantation of an allograft exposed to hydroxocobalamin. Furthermore, we emphasize the importance of optimal organ utilization and caution against unnecessary refusal.Source
Case Rep Transplant. 2018 Sep 9;2018:3753479. doi: 10.1155/2018/3753479. eCollection 2018. Link to article on publisher's site
DOI
10.1155/2018/3753479Permanent Link to this Item
http://hdl.handle.net/20.500.14038/40806PubMed ID
30271651Related Resources
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Copyright © 2018 Ryan J.Hendrix et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Distribution License
http://creativecommons.org/licenses/by/4.0/ae974a485f413a2113503eed53cd6c53
10.1155/2018/3753479
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Except where otherwise noted, this item's license is described as Copyright © 2018 Ryan J.Hendrix et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.