Successful treatment for a patient with hemophagocytic syndrome after a small-for-size graft liver transplantation

Tomoharu Yoshizumi, Akinobu Taketomi, Hiroto Kayashima, Noboru Harada, Hideaki Uchiyama, Yo Ichi Yamashita, Toru Ikegami, Yuji Soejima, Takashi Nishizaki, Mitsuo Shimada, Yoshihiko Maehara

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Abstract

Hemophagocytic syndrome (HPS) is a hematological disorder caused by activated T lymphocytes, which leads to the proliferation of stimulated macrophages that phagocytose and destroy circulating blood elements and their precursors within bone marrow, and lead to the further production of inflammatory cytokines. Living donor liver transplantation (LDLT) between adults has been performed to compensate for the shortage of available organs. There have been some reports concerning HPS after LDLT; however, its prognosis is disappointingly poor. In particular, there is no report of treated HPS developed after LDLT using small-for-size left lobe grafts. We herein report a case of HPS in a 63-year old woman who underwent LDLT using left lobe graft weighing only 330g. The HPS was diagnosed on postoperative day 13, and was successfully treated using a combination of intravenous immunoglobulin, granulocyte colony stimulating factor, conversion of calcineurin inhibitor and steroid pulse. The trigger of HPS may not only be systemic infection, but also hypercytokinemia caused by various factors. HPS is a fatal complication in immunologically compromised patients; however, early and accurate diagnosis could lead to an adequate treatment and improve the outcome.

Original languageEnglish
Pages (from-to)359-362
Number of pages4
JournalHepato-gastroenterology
Volume55
Issue number82-83
Publication statusPublished - Mar 1 2008

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All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

Cite this

Yoshizumi, T., Taketomi, A., Kayashima, H., Harada, N., Uchiyama, H., Yamashita, Y. I., ... Maehara, Y. (2008). Successful treatment for a patient with hemophagocytic syndrome after a small-for-size graft liver transplantation. Hepato-gastroenterology, 55(82-83), 359-362.