Early evidence of bone marrow dysfunction in children with indeterminate fulminant hepatic failure who ultimately develop aplastic anemia

American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons
Ricardo A MolinaMartín G Martín

Abstract

In children, aplastic anemia (AA) is a common complication associated with fulminant hepatic failure (FHF). The objective of this study was to determine whether specific pretransplantation clinical and laboratory characteristics can be used to distinguish between patients with FHF who are at higher risk of developing AA. We performed a retrospective case-control study to evaluate the clinical and laboratory characteristics of those patients who presented with evidence of FHF and eventually developed aplastic anemia. We identified nine patients with AA, and all had the indeterminate form of FHF and underwent liver transplantation (LTx). The AA patients were compared with a control group of 47 patients with indeterminate FHF that underwent transplantation and did not develop AA. We found that males were over-represented in the group of patients that developed AA (p = 0.01). Furthermore, during the pretransplant period, the AA group had a significantly lower white count (p = 0.005), absolute lymphocyte count (p = 0.004), and platelet count (p = 0.019) when compared with controls. We conclude that evidence of early bone marrow dysfunction is apparent before liver transplantation and the development of AA in a subset of patients wit...Continue Reading

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Citations

Sep 26, 2009·Journal of Pediatric Hematology/oncology·Vicky Rowena BreakeyYigal Dror
Jul 20, 2010·Lancet·William BernalJulia Wendon
Jul 4, 2007·Clinics in Liver Disease·John O'Grady
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Sep 3, 2014·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·L BathlaA N Langnas
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Jun 3, 2006·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Chris RheeMartín G Martín
Oct 24, 2006·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Michela G SchäppiHulya Ozsahin
Oct 31, 2007·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Avnish K SethGeoffrey Haydon
Mar 5, 2016·American Journal of Physiology. Gastrointestinal and Liver Physiology·Laurie D DeLeveLei Wang
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Jul 5, 2021·Acta Gastro-enterologica Belgica·A Islek, H Keskin
Feb 17, 2019·The Journal of Pediatrics·Catherine A ChapinEstella M Alonso

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