Shinoda Masahiro, Tanabe Minoru, Nagao Keisuke, Kitago Minoru, Fujisaki Hiroto, Odaira Masanori, Kawachi Shigeyuki, Itano Osamu, Obara Hideaki, Matsubara Kentaro, Shimojima Naoki, Fuchimoto Yasushi, Hoshino Ken, Amagai Masayuki, Kuroda Tatsuo, Kitagawa Yuko
1 Department of Surgery, Keio University, School of Medicine, Shinjuku, Tokyo, Japan.
Int Surg. 2012 Oct-Dec;97(4):356-9. doi: 10.9738/CC89.1.
We report on a 33-year-old female liver donor candidate who developed intraoperative latex-induced anaphylactic shock during surgery for living donor transplantation. She was the mother of the organ recipient, who was a 9-year-old boy with biliary atresia. We planned extended lateral segmentectomy for her. Although we dissected the ligament around the left lobe, the systolic blood pressure suddenly dropped and her body became flushed and warm. We administered transfusion and an ephedrine injection to recover the blood pressure. Because she recovered after the treatment, we restarted the procedure. However, she went into shock again within a few minutes. We decided to discontinue the operation. Postoperative blood tests revealed an increase in IgE-RAST and basophil activation, suggesting that the anaphylactic shock was induced by latex. Because latex allergy has become a public health problem, this allergy should be kept in mind as a potential donor operation risk.
我们报告了一名33岁的女性活体肝供体候选者，她在活体供体肝移植手术中发生了术中乳胶诱导的过敏性休克。她是器官接受者的母亲，接受者是一名患有胆道闭锁的9岁男孩。我们计划为她实施扩大左外叶切除术。尽管我们已经解剖了左叶周围的韧带，但她的收缩压突然下降，身体变得潮红且发热。我们进行了输血并注射麻黄碱以恢复血压。由于她在治疗后恢复，我们重新开始手术。然而，几分钟内她再次休克。我们决定停止手术。术后血液检查显示IgE-RAST和嗜碱性粒细胞活化增加，提示过敏性休克是由乳胶引起的。由于乳胶过敏已成为一个公共卫生问题，在潜在的供体手术风险中应考虑到这种过敏。
