Safety of liver donation after fatal intoxication with the tricyclic antidepressant trimipramine.
Author(s): Fattinger KE, Rentsch KM, Meier PJ, Dazzi H, Krahenbuhl S
Affiliation(s): Division of Clinical Pharmacology and Toxicology, Department of Internal Medicine, University Hospital, Zurich, Switzerland.
Publication date & source: 1996-11-15, Transplantation., 62(9):1259-62.
Publication type: Case Reports
We report the case of a patient receiving long-term treatment with the tricyclic antidepressant trimipramine who died 10 days after a trimipramine overdose. A few hours before death, the serum trimipramine concentration had fallen to 80 microg/L. Similar values are reported for patients taking therapeutic trimipramine doses. At this serum concentration, the liver content of trimipramine and it's 2-hydroxy and N-desmethyl metabolites was 1750 microg/kg, 850 microg/kg, and 225 microg/kg, respectively. The liver was morphologically normal. Back calculations suggest that a liver transplant obtained from a donor dying from a trimipramine overdose should be safe, if the serum trimipramine concentration has fallen below 2000 microg/L. If higher serum trimipramine concentrations are present, harvesting should be delayed to avoid trimipramine toxicity in the recipient.
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