Extracorporeal life support in a case of fatal flecainide and betaxolol poisoning allowing successful cardiac allograft

Ann Emerg Med. 2010 Oct;56(4):409-12. doi: 10.1016/j.annemergmed.2010.01.021. Epub 2010 Feb 20.

Abstract

Use of cardiac allograft for transplantation from donors after acute poisoning is a matter of debate because of potential toxic organ injuries, especially if death results from massive ingestion of cardiotoxic drugs. We report successful allograft cardiac transplantation from a brain-dead patient after severe flecainide and betaxolol self-poisoning requiring extracorporeal life support. Extracorporeal life support was initiated in the emergency department because of a refractory cardiac arrest caused by the cardiotoxicants' ingestion and continued after the onset of brain death to facilitate organ donation of the heart, liver, and kidneys. Forty-five months later, each organ recipient was alive, with normal graft function.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Arrhythmia Agents / poisoning*
  • Antihypertensive Agents / poisoning*
  • Betaxolol / poisoning*
  • Brain Death / diagnosis
  • Electrocardiography
  • Extracorporeal Circulation*
  • Female
  • Flecainide / poisoning*
  • Heart / drug effects
  • Heart / physiopathology
  • Heart Transplantation*
  • Humans
  • Tissue and Organ Procurement

Substances

  • Anti-Arrhythmia Agents
  • Antihypertensive Agents
  • Flecainide
  • Betaxolol