• J L Fortin, M Ruttimann, G Capellier, A Bigorie, S Ferlicot, and E Thervet.
• Emergency Medical Service of the Paris Fire Brigade,Paris, France. Fortin.jeanluc@wanadoo.fr
• Clin Toxicol (Phila). 2007 Jun 1;45(5):468-71.

BackgroundCyanide-poisoned patients are potential organ donors provided that organs are not damaged by the poison or by antidotal treatment.Case StudyA patient with third-degree burns and smoke inhalation-associated cyanide poisoning confirmed by measurements of whole blood cyanide was found in cardiac arrest and administered epinephrine and hydroxocobalamin (5 g + 5 g). Cardiac activity resumed, but the patient was declared brain dead on the third day of hospitalization when coma deteriorated to a shock state with refractory hypoxemia. Kidneys, heart, and liver were removed and transplanted into four patients. Gross pre-transplantation inspection of the donor organs and renal histology showed no evidence that hydroxocobalamin caused organ toxicity. Donor organs functioned normally through follow-up periods of several months.ConclusionAnoxic cardiac arrest following acute cyanide poisoning treated with hydroxocobalamin (5 g + 5 g) was not a contraindication to organ transplantation after confirmed encephalic death in this patient.

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