Safety of liver donation after fatal intoxication with the tricyclic antidepressant trimipramine

Transplantation. 1996 Nov 15;62(9):1259-62. doi: 10.1097/00007890-199611150-00014.

Abstract

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.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antidepressive Agents, Tricyclic / adverse effects*
  • Drug Overdose
  • Female
  • Humans
  • Liver / drug effects*
  • Liver / pathology
  • Liver Transplantation*
  • Tissue Donors*
  • Trimipramine / adverse effects*

Substances

  • Antidepressive Agents, Tricyclic
  • Trimipramine