Continuity of Care Following Intraoperative Cardiac Arrest due to Thymoglobulin®-induced AnaphylaxisCorrespondence Address :
Dr. Jose R Navas-Blanco,
Resident, Department of Anaesthesia and Perioperative Medicine, Henry Ford Hospital, 2799, West Grand Boulevard, CFP-341, Detroit, Michigan, USA.
Rabbit anti-thymocyte globulin (Thymoglobulin®, Sanofi-Aventis, Quebec, Canada) a purified gamma immune globulin obtained from the serum of rabbits immunised against human thymocytes, is widely used as an immunosuppressant agent to prevent acute rejection during solid organ transplantation. Anaphylaxis after first-time exposure to the drug is rare, but may be associated with devastating consequences. We present the case of a patient undergoing renal transplantation who developed intraoperative cardiac arrest due to severe allergic reaction immediately after initiation of Thymoglobulin® intravenous infusion. The patient was successfully resuscitated, but developed chronic chest pain from left-sided rib fractures sustained during chest compressions, and was evaluated by the same senior staff anaesthesiologist as an outpatient in the pain clinic.
A high level of suspicion from anaesthesia providers is paramount in the diagnosis and management of intraoperative drug-induced severe allergic reactions, furthermore there is an opportunity for continued care of these patients by anaesthesia providers beyond the return of spontaneous circulation.
Cardiopulmonary resuscitation complication, Rabbit anti-thymocyte globulin, Severe drug-induced allergic reaction
Jose R Navas-Blanco, Stephanie A Cook, David A Rico-Mora, Murali S Patri, Trevor J Szymanski. CONTINUITY OF CARE FOLLOWING INTRAOPERATIVE CARDIAC ARREST DUE TO THYMOGLOBULIN®-INDUCED ANAPHYLAXIS. Journal of Clinical and Diagnostic Research [serial online] 2018 April [cited: 2018 Sep 24 ]; 12:UD01-UD03. Available from
Date of Submission: Jul 17, 2017
Date of Peer Review: Oct 06, 2017
Date of Acceptance: Dec 08, 2017
Date of Publishing: Apr 01, 2018
FINANCIAL OR OTHER COMPETING INTERESTS: None.
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