Prolonged life-threatening anaphylaxis to Floseal during partial nephrectomy: A case report

Abstract

Floseal Hemostatic Matrix is a topical hemostatic agent used across specialties and commonly applied to the renal bed during partial nephrectomy. Here we present the first adult case of Floseal allergy in the literature. A 62-year-old man underwent partial nephrectomy for a Bosniak type IV cyst. After unclamping the kidney, the patient declined precipitously, later determined due to an anaphylactic reaction to the Floseal placed on the renal bed. The patient had a prolonged anaphylactic reaction that required ionotropic support for over 24 h, possibly due to continued exposure. His tryptase level was elevated, and allergy testing revealed an allergy to the gelatin matrix component of the Floseal. Floseal anaphylaxis should be considered during episodes of cardiovascular collapse after drug administration. However, consideration should be given to removing it to prevent continued exposure and weighed against the risk of prolonged surgery in an anaphylactic patient.

Keywords

Allergy / Anaphylaxis / Floseal / Gelatin / Partial nephrectomy

Acknowledgments

None.

Statement of ethics

As the patient directly consented for the publication of this case, this work is exempt from a Human Research Ethics Committee review at our institution. All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Conflicts of interest statement

The authors declare no conflicts of interest in relation to this work.

Funding source

No funding was obtained for this work.

Author contributions

GM, PM: Study concept and design;

GM: Data acquisition, drafting of manuscript;

GM, DF, YL, PM: Critical revision of the manuscript.

Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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