Korean J Anesthesiol.  2014 Jun;66(6):467-471. 10.4097/kjae.2014.66.6.467.

Prolonged post-reperfusion syndrome during multivisceral organ transplantation in a pediatric patient: a case report

• Park YS
• Oh JY
• Hwang BY
• Moon Y
• Lee HM
• Hwang GS

• KMID: 2237953
• DOI: http://doi.org/10.4097/kjae.2014.66.6.467

Abstract

Multivisceral organ transplantation involves the transplantation of three or more abdominal organs, including small bowel, duodenum, stomach, liver, pancreas, colon, and so on. The large amounts of cold and acidic loading into systemic circulation from the graft during multivisceral organ transplantation may result in severe post-reperfusion syndrome (PRS). We describe here a 6-year-old pediatric patient with chronic intestinal pseudo-obstruction who experienced prolonged PRS and severe metabolic acidosis during seven abdominal organ transplantation including the liver, spleen, stomach, duodenum, small bowel, colon and pancreas. The hypotensive period lasted approximately 10 minutes after graft reperfusion and was accompanied by severe metabolic acidosis and hypothermia. Since PRS can be easily associated with adverse outcomes, such as poor early graft function and primary non-function, not only meticulous surveillance for aggravating factors for PRS but also their immediate correction were necessary in managing a pediatric patient undergoing multivisceral organ transplantation.

Keyword

Intestine; Liver; Metabolic acidosis; Primary graft dysfunction; Reperfusion; Transplantation

MeSH Terms

Acidosis
Child
Colon
Duodenum
Humans
Hypothermia
Intestinal Pseudo-Obstruction
Intestines
Liver
Organ Transplantation*
Pancreas
Primary Graft Dysfunction
Reperfusion
Spleen
Stomach
Transplantation
Transplants*