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Hyperacute rejection from a donor who died of carbamate intoxication--a case report
Yi-Hsin Chan1, Kuo-Ping Liew, Charles Chien-Feng Sun
1Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan.
Insights
Acute carbamate intoxication can lead to severe cardiac issues. This case highlights a fatal heart transplant outcome from a donor with carbamate poisoning, underscoring the risks.
Area of Science:
- Cardiology
- Toxicology
- Transplantation
Background:
- Acute carbamate intoxication is known to cause cardiac manifestations.
- Cardiomyopathy and arrhythmias are potential complications.
Observation:
- A heart transplant recipient died 24 hours post-operation due to acute left ventricular dysfunction.
- The donor had died from brain death secondary to carbamate intoxication.
Findings:
- The case underscores the potential cardiac toxicity of carbamate intoxication.
- Graft failure occurred in a heart transplant recipient from a carbamate-intoxicated donor.
Implications:
- This case raises concerns about the safety of using organs from carbamate-intoxicated donors for transplantation.
- Further research is needed to understand the long-term effects and risks associated with carbamate exposure on organ viability for transplantation.
Abstract:
Acute carbamate intoxication can cause cardiac manifestations. We present the case of a 53-year-old man who had been a heavy smoker, admitted to our hospital for recent anterior wall myocardial infarction complicated with congestive heart failure. Percutaneous transluminal coronary angioplasty with stent implantation, coronary artery bypass graft, and mitral annuloplasty were performed, but refractory heart failure and ventricular arrhythmia were still noted. He received orthotropic heart transplantation 7 days later. The donor was a 50-year-old man who had died of brain death due to carbamate intoxication, and the crossmatch before transplantation was negative. The recipient died 24 hours after the operation due to acute left ventricular dysfunction. This report reviews the cardiac manifestations of acute carbamate intoxication and the possibility of heart transplantations from donors who died of carbamate intoxication.
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