TY - JOUR
T1 - Orthotopic liver transplantation in a malignant hyperthermia susceptible patient
AU - Schmidt, Annette
AU - Tzanova, Irene
AU - Köbler, Andrea M.K.
AU - Wisser, Gregor J.F.
AU - Kentner, Rainer
PY - 2005/11
Y1 - 2005/11
N2 - We present a patient with hepatitis C and D and hepatocellular carcinoma who underwent preoperative evaluation for orthotopic liver transplantation. In his past medical history, he reported a life-threatening event during tonsillectomy in 1975. Intubation was impossible due to extreme jaw muscle tension, followed by excessive elevation in body temperature, tachycardia, and coma for a few days. We evaluated him for malignant hyperthermia, according to the European Malignant Hyperthermia Group Protocol, and found him highly positive in both the halothane and caffeine test, respectively. Three months later, we performed an orthotopic liver transplantation. During retransplantation 4 years later, due to ischemic-type biliary lesions, he suffered massive intraoperative bleeding. Blood products, as well as coagulation factors and aprotinin, were well tolerated. Anesthesia was performed in a trigger-free total intravenous technique without dantrolene prophylaxis, but dantrolene was readily available in sufficient quantities in the operating room. The patient did not encounter a malignant hyperthermia crisis in either perioperative period.
AB - We present a patient with hepatitis C and D and hepatocellular carcinoma who underwent preoperative evaluation for orthotopic liver transplantation. In his past medical history, he reported a life-threatening event during tonsillectomy in 1975. Intubation was impossible due to extreme jaw muscle tension, followed by excessive elevation in body temperature, tachycardia, and coma for a few days. We evaluated him for malignant hyperthermia, according to the European Malignant Hyperthermia Group Protocol, and found him highly positive in both the halothane and caffeine test, respectively. Three months later, we performed an orthotopic liver transplantation. During retransplantation 4 years later, due to ischemic-type biliary lesions, he suffered massive intraoperative bleeding. Blood products, as well as coagulation factors and aprotinin, were well tolerated. Anesthesia was performed in a trigger-free total intravenous technique without dantrolene prophylaxis, but dantrolene was readily available in sufficient quantities in the operating room. The patient did not encounter a malignant hyperthermia crisis in either perioperative period.
KW - Anesthesia
KW - Aprotinin
KW - Malignant hyperthermia
KW - Orthotopic liver transplantation
UR - http://www.scopus.com/inward/record.url?scp=27744442884&partnerID=8YFLogxK
U2 - 10.1016/j.jclinane.2004.11.005
DO - 10.1016/j.jclinane.2004.11.005
M3 - Article
C2 - 16297758
AN - SCOPUS:27744442884
VL - 17
SP - 558
EP - 561
JO - Journal of Clinical Anesthesia
JF - Journal of Clinical Anesthesia
SN - 0952-8180
IS - 7
ER -