Fatal hemophagocytic syndrome after living-related liver transplantation: a report of two cases.

Abstract:

BACKGROUND:Hemophagocytic syndrome (HPS) is a serious hematological disorder caused by activated T lymphocytes in immunologically compromised patients. There is no report of HPS in liver transplant recipients. METHODS:Among 135 patients who underwent living-related liver transplantation between June 1990 and October 2000, HPS developed in two pediatric patients (1.5%) on the 15th and 134th postoperative day, respectively. The courses of these patients were evaluated. RESULTS:The cause of HPS was unknown in patient 1 and suspected to be Epstein-Barr virus infection in patient 2. The course of patient 2 was also complicated by posttransplant lymphoproliferative disorder. Both patients had high fever, pancytopenia, coagulopathy, and marked elevation of serum-soluble interleukin 2 receptor, serum ferritin, and urine beta2-microglobulin levels. The diagnosis was established based on clinical findings, laboratory data, and bone marrow biopsy. Both patients died in an acute course despite intensive care. CONCLUSIONS:HPS should be recognized as a severe hematological complication in liver transplant patients. Prompt institution of adequate treatment is necessary to prevent fatality.

journal_name

Transplantation

journal_title

Transplantation

authors

Chisuwa H,Hashikura Y,Nakazawa Y,Kamijo T,Nakazawa K,Nakayama J,Oh-Ishi T,Ikegami T,Terada M,Kawasaki S

doi

10.1097/00007890-200112150-00024

subject

Has Abstract

pub_date

2001-12-15 00:00:00

pages

1843-6

issue

11

eissn

0041-1337

issn

1534-6080

journal_volume

72

pub_type

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