Successful Management of a Lung Transplant Patient With an Anaphylactic Reaction to Methylprednisolone Sodium...

Area of Science:

• Immunology
• Transplantation Medicine
• Clinical Pharmacology

Background:

• Methylprednisolone sodium succinate (MPS) is a crucial immunosuppressant in solid organ transplantation.
• Anaphylaxis to MPS is a rare but documented adverse reaction, primarily reported in kidney and liver transplant recipients.
• No prior reports exist detailing anaphylactic reactions to MPS specifically in lung transplant patients.

Purpose of the Study:

• To report the first case of anaphylaxis to MPS in a lung transplant recipient.
• To evaluate the safety and efficacy of alternative corticosteroid therapies in this patient population.
• To establish dexamethasone and oral prednisolone as viable alternatives for lung transplant recipients with MPS hypersensitivity.

Main Methods:

• A lung transplant candidate with a history of anaphylaxis to MPS underwent drug provocation testing.
• Dexamethasone was identified as a safe alternative and administered during and after the lung transplant procedure.
• The patient was subsequently transitioned to oral prednisolone.

Main Results:

• The patient tolerated dexamethasone and oral prednisolone without anaphylactic reactions.
• Successful lung transplantation was achieved, with no evidence of allograft rejection.
• The patient was discharged in stable condition approximately one month post-operation.

Conclusions:

• Dexamethasone and oral prednisolone serve as effective and safe alternatives for lung transplant recipients experiencing anaphylaxis to MPS.
• This approach can mitigate risks associated with MPS hypersensitivity, facilitating successful transplantation outcomes.
• Clinicians should consider alternative corticosteroids in patients with a known history of MPS-induced anaphylaxis undergoing lung transplantation.