Hydroxocobalamin for treatment of catecholamine-resistant vasoplegia during liver transplantation
Brent T. Boettcher, Harvey J. Woehlck, Hemanckur Makker, Paul S. Pagel, Julie K. Freed
Abstract
INTRODUCTION: Catecholamine-resistant vasoplegia is a potentially devastating complication during liver transplantation. Hydroxocobalamin has emerged as a treatment for vasoplegia associated with cardiac surgery, liver transplantation, and septic shock. PRESENTATION OF CASE: We performed a retrospective review of patients who underwent liver transplantation between October 2015 and May 2020 to evaluate the efficiency of hydroxocobalamin in this setting. DISCUSSION: A total of 137 patients underwent liver transplantation, of which 20 received hydroxocobalamin for vasoplegia. Administration of hydroxocobalamin increased mean arterial pressure and reduced vasoactive drug requirements. CONCLUSION: This case series adds to the previous individual reports describing the use of hydroxocobalamin during liver transplantation suggesting hydroxocobalamin can mitigate refractory hypotension from catecholamine resistant vasoplegia during liver transplantation.