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Atypical malignant hyperthermia with persistent hyperkalaemia during renal transplantation
1Department of Anesthesiology, Ohio State University College of Medicine, Columbus 43210.
Summary
Malignant hyperthermia, a rare anesthesia complication, was triggered by isoflurane during kidney transplant surgery. This case highlights successful treatment and persistent electrolyte imbalances post-procedure.
Area of Science:
- Anesthesiology
- Nephrology
- Pharmacology
Background:
- Renal transplantation is a critical procedure for end-stage renal disease.
- General anesthesia involves potential risks, including rare adverse reactions.
- Isoflurane is a common inhalation anesthetic agent used in surgical settings.
Observation:
- A 35-year-old male undergoing living-related renal transplantation presented with severe hyperkalemia, hyponatremia, hypercapnia, and hyperthermia.
- These symptoms emerged during anesthesia involving oxygen-nitrous oxide, isoflurane, and atracurium.
- The patient exhibited signs consistent with malignant hyperthermia.
Findings:
- This is the first reported case of malignant hyperthermia triggered by isoflurane during renal transplantation.
- Successful treatment of malignant hyperthermia was achieved.
- Significant electrolyte abnormalities, including hyperkalemia and hyponatremia, persisted for up to 12 hours post-surgery.
Implications:
- Anesthesiologists should be vigilant for malignant hyperthermia in renal transplant patients, especially when using isoflurane.
- Early recognition and prompt treatment are crucial for managing malignant hyperthermia.
- Persistent electrolyte disturbances require careful monitoring and management following renal transplantation and anesthesia-induced adverse events.