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A case report: anaphylaxis to cefazolin during renal transplant surgery
Allergy, Asthma & Clinical Immunology ( IF 2.7 ) Pub Date : 2021-05-29 , DOI: 10.1186/s13223-021-00559-w
Kaveh Hemati , Shelley Gierat , Garrett R. Roll , Odmara L. Barreto Chang

While there exist case reports of anaphylaxis occurring during renal transplant surgery, descriptions of continuing transplant surgery post-anaphylaxis have been scarce. Anaphylactic reactions that present solely with hypotension without pulmonary or mucocutaneous signs have yet to be described during renal transplant surgery. Here we report a case of a 33-year-old female with end-stage renal disease who underwent cadaveric renal transplant. She developed anaphylaxis following the administration of cefazolin. Despite this reaction, the surgery was ultimately completed after patient stabilization, and the patient had excellent graft function postoperatively. The patient had an elevated tryptase at the time of the reaction and postoperative allergy testing revealed a positive intradermal test to cefazolin. Written informed consent was obtained from the patient for all procedures, studies, and publication of this case report. This is the first case of a successful zero-mismatch cadaveric renal transplant following an anaphylactic reaction to cefazolin. Although anaphylaxis during transplant surgery typically warrants cancellation due to the hemodynamic effects that may lead to graft dysfunction, here we describe a case where surgery was continued following patient stabilization. The decision to proceed with surgery despite an intraoperative emergency along with the management and workup of intraoperative anaphylaxis are described, which can be beneficial for others who are presented with similar scenarios in the future.

中文翻译:

病例报告:肾移植手术中头孢唑啉过敏反应

虽然存在肾移植手术期间发生过敏反应的病例报告,但关于过敏反应后继续移植手术的描述很少。在肾移植手术期间,尚未描述仅表现为低血压而没有肺部或皮肤粘膜体征的过敏反应。在这里,我们报告了一例接受尸体肾移植的 33 岁女性终末期肾病患者。她在服用头孢唑林后出现过敏反应。尽管有这种反应,但最终在患者稳定后完成了手术,患者术后移植物功能良好。患者出现反应时类胰蛋白酶升高,术后过敏试验显示头孢唑啉皮内试验呈阳性。本病例报告的所有程序、研究和出版均获得了患者的书面知情同意。这是对头孢唑林发生过敏反应后成功进行零错配尸体肾移植的首例病例。尽管由于可能导致移植物功能障碍的血流动力学影响,移植手术期间的过敏反应通常需要取消,但这里我们描述了一个在患者稳定后继续手术的案例。描述了在术中紧急情况下继续手术的决定以及术中过敏反应的管理和检查,这对将来遇到类似情况的其他人可能有益。这是对头孢唑林发生过敏反应后成功进行零错配尸体肾移植的首例病例。尽管由于可能导致移植物功能障碍的血流动力学影响,移植手术期间的过敏反应通常需要取消,但这里我们描述了一个在患者稳定后继续手术的案例。描述了在术中紧急情况下继续手术的决定以及术中过敏反应的管理和检查,这对将来遇到类似情况的其他人可能有益。这是对头孢唑林发生过敏反应后成功进行零错配尸体肾移植的首例病例。尽管由于可能导致移植物功能障碍的血流动力学影响,移植手术期间的过敏反应通常需要取消,但这里我们描述了一个在患者稳定后继续手术的案例。描述了在术中紧急情况下继续手术的决定以及术中过敏反应的管理和检查,这对将来遇到类似情况的其他人可能有益。在这里,我们描述了在患者稳定后继续手术的情况。描述了在术中紧急情况下继续手术的决定以及术中过敏反应的管理和检查,这对将来遇到类似情况的其他人可能有益。在这里,我们描述了在患者稳定后继续手术的情况。描述了在术中紧急情况下继续手术的决定以及术中过敏反应的管理和检查,这对将来遇到类似情况的其他人可能有益。
更新日期:2021-05-30
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