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亚硝酸盐中毒后经神经学判定死亡捐献后的成功肝移植

Successful Liver Transplantation After Neurologically Determined Death Donation Following Sodium Nitrite Poisoning.

作者信息

Mathuram Thiyagarajan Umasankar, James Shapiro A M

机构信息

Surgery, University of Alberta Hospital, Edmonton, CAN.

出版信息

Cureus. 2023 Jan 2;15(1):e33278. doi: 10.7759/cureus.33278. eCollection 2023 Jan.

Abstract

Sodium nitrite poisoning has been reported with increasing frequency since 2017 and popularized on social media as an effective means to commit suicide. Though accidental, non-intentional consumption has been reported, it is uncommon. Sodium nitrite is a colorless, odorless, yellowish-white crystalline material that resembles table salt, is easily ingested for self-harm, and is readily accessible through purchase from online portals at low cost. The chemical is used industrially as a curing agent for meat, fish, and cheese, as it inhibits  and prevents botulism. We herein report a successful case of liver transplantation from an organ donor who suffered brain death after intentional sodium nitrite consumption. Despite conflicting evidence on sodium nitrite's toxic versus protective effects on the liver, our transplant recipient showed normal graft function in the four months following liver transplantation. It would have been helpful and reassuring to have had access to similar positive case reports when deciding to use such a donor.

摘要

自2017年以来,亚硝酸钠中毒的报告频率不断增加,并且在社交媒体上作为一种有效的自杀手段而广泛传播。尽管有意外的非故意摄入的报告,但这种情况并不常见。亚硝酸钠是一种无色、无味、淡黄色白色的结晶物质,类似于食盐,很容易被用于自我伤害,并且通过从在线平台低成本购买即可轻易获得。该化学品在工业上用作肉类、鱼类和奶酪的防腐剂,因为它能抑制和预防肉毒杆菌中毒。我们在此报告一例成功的肝移植病例,器官供体在故意摄入亚硝酸钠后发生脑死亡。尽管关于亚硝酸钠对肝脏的毒性与保护作用存在相互矛盾的证据,但我们的移植受者在肝移植后的四个月内移植肝功能正常。在决定使用这样的供体时,如果能有类似的阳性病例报告,将会很有帮助且令人安心。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c5a2/9892231/dbc384188cae/cureus-0015-00000033278-i01.jpg

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