Use of Intravenous Hydroxocobalamin for Vasoplegic Syndrome in Simultaneous Liver-Kidney Transplant: A Case Report.

Abstract

Vasoplegic syndrome can occur after reperfusion in liver transplantation. Generally, vasopressor infusions along with volume resuscitation are used to combat this process. There are case reports of the use of hydroxocobalamin to improve vasoplegia in liver transplant and cardiac surgery. In this case report, we describe a patient who received hydroxocobalamin for a simultaneous liver-kidney transplant. Use of this medication facilitated a prompt decrease of very high-dose vasopressor infusions and allowed completion of the kidney transplantation portion of this case. To our knowledge, use in combined liver-kidney transplant has not been described. In light of the dearth of medications to improve vasoplegia outside of vasopressor infusions, the use of hydroxocobalamin as a therapeutic intervention may gain importance.

• Authors: Devin Weinberg, Kati Running, Philip L Kalarickal, Gaurav P Patel
• Journal: Transplantation proceedings (Transplant Proc) Vol. 53 Issue 4 Pg. 1300-1302 (May 2021) ISSN: 1873-2623 [Electronic] United States
• PMID: 33246585 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2020 Elsevier Inc. All rights reserved.

Chemical References

• Vasoconstrictor Agents
• Hydroxocobalamin

Topics

• Echocardiography
• End Stage Liver Disease (surgery)
• Humans
• Hydroxocobalamin (therapeutic use)
• Kidney Transplantation (adverse effects)
• Liver Transplantation (adverse effects)
• Male
• Middle Aged
• Vasoconstrictor Agents (therapeutic use)
• Vasoplegia (diagnosis, drug therapy, etiology)