Journal of Liver

Successful extracorporeal resuscitation after perioperative anaphylactic shock during living donor liver transplantation

World Congress on Hepatitis

July 20-22, 2015 Orlando, Florida, USA

Ching-Hui Shen

Posters-Accepted Abstracts: J Liver

Abstract:

A 46-year-old dentist was admitted for emergent donor hepatectomy. His circulatory condition became unstable 75 minutes after induction and then deteriorated to ventricular fibrillation due to latex-induced anaphylaxis. Following 35 minutes of futile conventional resuscitation without spontaneous cardiac rhythm, extracorporeal resuscitation was initiated and electric cardiac activity returned 10 minutes later. He was discharged home without any sequelae. Few details are provided about the perioperative mortality but it seems that the surgical donation procedure was the main cause. Only one death was associated with anesthesia due to anaphylaxis.The most common agents of perioperative anaphylaxis are neuromuscular blocking drugs (60%) followed by latex (12-16%) and antibiotics (8%). For adult in-hospital cardiac arrest of cardiac origin, patients may benefit from extracorporeal life support with both short-term and long-term survival advantages compared with conventional cardiopulmonary resuscitation. Donor safety is extremely important. To rescue and resuscitate donor during the occurrence of crisis such as anaphylactic shock is important. More rapid response and more advanced procedure like extracorporeal life support should be applied as early as possible if initial conventional resuscitation fails. We hope that sharing our experience in this case will lead to better care of donors.