End-stage liver cirrhosis with severe autoimmune hemolytic anemia, treated by blood type-incompatible living donor liver transplantation: A case report

K. Sanefuji, T. Ikegami, S. Nagata, K. Sugimachi, T. Gion, H. Uchiyama, Y. Soejima, A. Taketomi, K. Shirabe, Y. Maehara

Research output: Contribution to journalArticle

Abstract

We present a case of successful living donor liver transplantation (LDLT) for liver cirrhosis caused by hepatitis B virus with severe autoimmune hemolytic anemia (AIHA) using an ABO-incompatible (ABOi) graft. The patient was a 47-year-old woman who had a history of ruptured esophageal varices, accumulation of intractable ascites, frequent hepatic encephalopathy and severe anemia, with a hemoglobin value of approximately 3 g/dL due to AIHA. We treated the patient by LDLT using an ABOi liver graft. The treatment strategy included anti-CD20 antibody, plasma exchange and transfusion before LDLT. The patient's anemia improved after surgery; she required only 2 units of irradiated red blood cell concentrates-leukocytes reduced. The patient was discharged from the hospital on postoperative day 35. Two years after surgery, the patient still shows normal hepatic and hematological findings. The immunomodulation protocol for ABOi LDLT was effective not only to avoid humoral reactions associated with ABOi LDLT, but also those associated with AIHA.

Original languageEnglish
Pages (from-to)2087-2089
Number of pages3
JournalTransplantation Proceedings
Volume43
Issue number5
DOIs
Publication statusPublished - Jun 1 2011

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Autoimmune Hemolytic Anemia
Living Donors
Liver Cirrhosis
Liver Transplantation
Anemia
Transplants
Plasma Exchange
Immunomodulation
Hepatic Encephalopathy
Esophageal and Gastric Varices
Liver
Ascites
Hepatitis B virus
Anti-Idiotypic Antibodies
Hemoglobins
Leukocytes
Erythrocytes

All Science Journal Classification (ASJC) codes

  • Surgery
  • Transplantation

Cite this

End-stage liver cirrhosis with severe autoimmune hemolytic anemia, treated by blood type-incompatible living donor liver transplantation : A case report. / Sanefuji, K.; Ikegami, T.; Nagata, S.; Sugimachi, K.; Gion, T.; Uchiyama, H.; Soejima, Y.; Taketomi, A.; Shirabe, K.; Maehara, Y.

In: Transplantation Proceedings, Vol. 43, No. 5, 01.06.2011, p. 2087-2089.

Research output: Contribution to journalArticle

Sanefuji, K. ; Ikegami, T. ; Nagata, S. ; Sugimachi, K. ; Gion, T. ; Uchiyama, H. ; Soejima, Y. ; Taketomi, A. ; Shirabe, K. ; Maehara, Y. / End-stage liver cirrhosis with severe autoimmune hemolytic anemia, treated by blood type-incompatible living donor liver transplantation : A case report. In: Transplantation Proceedings. 2011 ; Vol. 43, No. 5. pp. 2087-2089.
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