Abstract：
Intraoperative anaphylaxis is a life threatening and multiorgan system hypersensitivity reaction that frequently leads to cessation of operations. Despite the incidence of Cefazolin allergy being on the rise, the cases of anaphylaxis to Cefazolin during surgeries and its management are seldom reported.
We present two patients with no known beta-lactam allergy and end stage kidney disease who received perioperative intravenous Cefazolin for planned deceased kidney transplant surgery at our academic medical center. Both patients developed anaphylaxes approximately three minutes following the administration of the antibiotic and experienced severe, refractory hypotension that required the use of vasopressors. The severity of the anaphylactic reactions resulted in the cessation of the transplant operation and multiple days of intensive care unit admission.
Peri-or intraoperative anaphylaxis to Cefazolin is on the rise and its consequences in transplant candidates are even more dire given the pre-existing end organ failure, financial burden for health care system, potential loss of donor organs, and emotional burden for recipients and their families. These are the first two cases of reported Cefazolin-induced anaphylaxis that actually resulted in aborting the kidney transplant operation. In addition, cases of previously reported Type 1 hypersensitivity to Cefazolin as prophylaxis for operations were reviewed and the allergy workups were discussed.
We present two patients with no known beta-lactam allergy and end stage kidney disease who received perioperative intravenous Cefazolin for planned deceased kidney transplant surgery at our academic medical center. Both patients developed anaphylaxes approximately three minutes following the administration of the antibiotic and experienced severe, refractory hypotension that required the use of vasopressors. The severity of the anaphylactic reactions resulted in the cessation of the transplant operation and multiple days of intensive care unit admission.
Peri-or intraoperative anaphylaxis to Cefazolin is on the rise and its consequences in transplant candidates are even more dire given the pre-existing end organ failure, financial burden for health care system, potential loss of donor organs, and emotional burden for recipients and their families. These are the first two cases of reported Cefazolin-induced anaphylaxis that actually resulted in aborting the kidney transplant operation. In addition, cases of previously reported Type 1 hypersensitivity to Cefazolin as prophylaxis for operations were reviewed and the allergy workups were discussed.
摘要：
术中过敏反应是一种危及生命的多器官系统过敏反应，经常导致手术停止。尽管头孢唑啉过敏的发生率在上升,很少报道在手术过程中头孢唑林的过敏反应及其处理。
我们介绍了两名没有已知β-内酰胺过敏和终末期肾病的患者，他们在我们的学术医疗中心接受了围手术期静脉注射头孢唑林，用于计划中的死亡肾脏移植手术。两名患者在服用抗生素后大约三分钟出现过敏反应，并经历了严重的症状，需要使用血管加压药的难治性低血压。过敏反应的严重程度导致了移植手术的停止和几天的重症监护病房入院。
头孢唑啉的围手术期或术中过敏反应正在上升，考虑到先前存在的终末器官衰竭，其在移植候选者中的后果更加可怕，医疗系统的财政负担，供体器官的潜在损失，以及接受者及其家人的情感负担。这是报告的头孢唑啉引起的过敏反应的前两例，实际上导致了肾脏移植手术的中止。此外,回顾了以前报道的头孢唑林1型超敏反应作为手术预防的病例，并讨论了过敏检查。
我们介绍了两名没有已知β-内酰胺过敏和终末期肾病的患者，他们在我们的学术医疗中心接受了围手术期静脉注射头孢唑林，用于计划中的死亡肾脏移植手术。两名患者在服用抗生素后大约三分钟出现过敏反应，并经历了严重的症状，需要使用血管加压药的难治性低血压。过敏反应的严重程度导致了移植手术的停止和几天的重症监护病房入院。
头孢唑啉的围手术期或术中过敏反应正在上升，考虑到先前存在的终末器官衰竭，其在移植候选者中的后果更加可怕，医疗系统的财政负担，供体器官的潜在损失，以及接受者及其家人的情感负担。这是报告的头孢唑啉引起的过敏反应的前两例，实际上导致了肾脏移植手术的中止。此外,回顾了以前报道的头孢唑林1型超敏反应作为手术预防的病例，并讨论了过敏检查。
