Suspected Anti-Thymocyte Globulin induced severe Intraoperative Anaphylaxis in a Cadaveric Donor Renal Transplant recipient: A Case Report

Anti-thymocyte globulin related anaphylaxis is rare but life-threatening. Thymoglobulin is a purified, pasteurized, rabbit-derived T-cell depleting polyclonal gamma immunoglobulin, obtained by immunization of rabbits with human thymocytes, commonly used for treatment of acute rejection in renal transplantation and induction immunosuppression. We report a case of a cadaveric renal transplant recipient who developed intraoperative anaphylactic shock, likely triggered by thymoglobulin administration. This case report signifies the importance of prompt diagnosis and management of intraoperative anaphylaxis, as early intervention is crucial for achieving a successful outcome. Communication between the anaesthesia team, nephrologists and surgeons played a key role in taking the decision of continuing the transplant.