Hemophagocytic syndrome after living donor liver transplantation: a case report with a review of the literature

Surgical Case Reports
Norifumi IsedaYuji Soejima

Abstract

Hemophagocytic syndrome (HPS) is a rare and potentially fatal complication following liver transplantation. A 63-year-old woman with decompensated liver cirrhosis secondary to hepatitis B virus infection underwent living donor liver transplantation using the right posterior section of her husband's liver (graft volume, 581 g; 56.8% of the recipient's standard liver volume). She developed small-for-size syndrome on postoperative day (POD) 7, and HPS was diagnosed on POD 12 by bone marrow aspiration (white blood cells, 300/μL; neutrophils, 30/μL). Given that she tested negative for viral (hepatitis B virus and cytomegalovirus) and bacterial infections, it was considered likely to be secondary HPS. Steroid pulse therapy was initiated, and her white blood cell count increased to 4290/μL on POD 15, indicating that her peripheral blood leukocytes had improved. There were no surgical complications, but the patient died of prolonged graft dysfunction with bacterial sepsis on POD 14. We report a rare case of HPS occurring 2 weeks after living donor liver transplantation with a right posterior section graft, diagnosed early via bone marrow aspiration. This clinical course implies an association between HPS and graft dysfunction such as s...Continue Reading

References

Jun 27, 2003·Transplantation Proceedings·Z KarasuY Tokat
Apr 14, 2006·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Y SoejimaY Maehara
Jun 27, 2006·Transplantation Proceedings·N AkamatsuM Makuuchi
Aug 29, 2006·Pediatric Blood & Cancer·Jan-Inge HenterGritta Janka
Jun 27, 2008·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Tomoharu YoshizumiYoshihiko Maehara
Oct 22, 2009·Transplant International : Official Journal of the European Society for Organ Transplantation·Kensaku SanefujiYoshihiko Maehara
Oct 5, 2011·Surgery Today·Akihiko SoyamaTakashi Kanematsu
Apr 13, 2012·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·T IkegamiY Maehara
Jun 4, 2014·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Tomoharu YoshizumiYoshihiko Maehara
Sep 4, 2017·Current Opinion in Immunology·Fernando E Sepulveda, Geneviève de Saint Basile
Sep 26, 2017·Current Treatment Options in Rheumatology·Lehn K Weaver, Edward M Behrens

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Citations

Sep 18, 2021·Transplant Infectious Disease : an Official Journal of the Transplantation Society·Elena Valdés FrancíAna Isabel Sánchez Fructuoso

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Methods Mentioned

BETA
biopsy
bone marrow aspiration

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