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KMID : 0352120170320010076
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Journal of Kyung Hee University
2017 Volume.32 No. 1 p.76 ~ p.82
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Phenylephrine and Norepinephrine Pretreatment for Preventing Postreperfusion Syndrome during a Pediatric Multivisceral Organ Transplantation: A Case Report
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Chae Min-Suk
Lee Nu-Ri
Park Da-Hye
Lee Ji-Soo
Jung Hyun-Sik
Park Chul-Soo
Lee Jae-Min
Choi Jong-Ho
Hong Sang-Hyun
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Abstract
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Multivisceral organ transplantation is the final treatment option for children that have difficulty in absorbing sufficient enteral nutrition. Postreperfusion syndrome (PRS) is frequently seen in solid organ transplantation, and has a negative effect on graft and/or recipient outcome. Here, we describe a 30- month-old male toddler with chronic intestinal pseudoobstruction treated with multivisceral organ transplantation, including of the stomach, duodenum, pancreas, spleen, jejunum, ileum, and colon, but not the rectum. Immediately before multivisceral graft reperfusion, the recipient was pretreated with an intravenous bolus of phenylephrine (2.0 μg/kg) with increasing norepinephrine infusion. Pretreatment with phenylephrine and norepinephrine to prevent PRS reduced the severity and duration of severe hypotension and metabolic disturbance after graft reperfusion. As prolonged severe hypotension during graft reperfusion is associated with adverse outcomes, timely pretreatment with vasopressors before graft reperfusion is required to attenuate the development of severe PRS in pediatric multivisceral organ transplantation.
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KEYWORD
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Transplantation, Intestines, Reperfusion
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