Unforeseen Pseudotumoral Colitis in Deceased Donor with Carbon Monoxide Intoxication

Carbon monoxide intoxication is a well-known cause of hypoxic injury primarily to the central nervous system and myocardium, but the bowel may be also vulnerable. Patients succumbing to carbon monoxide poisoning are usually considered unsuitable for organ procurement and they are routinely rejected in many transplant centers. As the organ supply is by far insufficient to meet the needs of patients from the waiting lists for transplant, there is a greater effort to increase the donor organ pool. Therefore special attention is being devoted to such “marginal” or “high-risk “donors. Similarly, tumors revealed during organ procurement require careful consideration in the evaluation of organ donors and transplant recipients. We herein report a multiorgan procurement from a victim of carbon monoxide poisoning who underwent a prolonged cardiopulmonary resuscitation and was intraoperatively diagnosed with a right colon tumor. Intraoperative frozen section examination ruled out malignancy and revealed an acute ischemic colitis. It is suggested that patients dying of carbon monoxide poisoning who are considered appropriate donors, may have intraoperatively revealed pseudotumoral ischemic colitis which does not preclude multiorgan procurement.