TY - JOUR
T1 - Thrombotic microangiopathy caused by severe graft dysfunction after living donor liver transplantation
T2 - Report of a case
AU - Matsuda, Daisuke
AU - Toshima, Takeo
AU - Ikegami, Toru
AU - Harimoto, Norifumi
AU - Yamashita, Yo Ichi
AU - Yoshizumi, Tomoharu
AU - Soejima, Yuji
AU - Ikeda, Tetsuo
AU - Shirabe, Ken
AU - Maehara, Yoshihiko
N1 - Copyright:
Copyright 2014 Elsevier B.V., All rights reserved.
PY - 2014/4
Y1 - 2014/4
N2 - Thrombotic microangiopathy (TMA) is a life-threatening complication after transplantation including liver transplantation, and its typical clinical picture is characterized by hemolytic anemia, thrombocytopenia, renal dysfunction, neurological abnormalities, and fever. We report the case of a 56-year-old female with end-stage liver disease who underwent living donor liver transplantation (LDLT), and whose postoperative course was characterized by renal failure and progressive hyperbilirubinemia. Two weeks after LDLT, she started to show progressive thrombocytopenia, anemia, oliguria, and encephalopathy. From these clinical manifestations, she was diagnosed as having TMA and underwent plasma exchanges with continuous hemodialysis under temporary holding calcineurin inhibitors. The patient promptly responded to the treatment, with improved hematological, hepatic, and renal conditions, and was discharged from hospital a month later in a stable condition. We describe this case of TMA after LDLT with poor graft function and extensively review the disease in liver transplant recipients.
AB - Thrombotic microangiopathy (TMA) is a life-threatening complication after transplantation including liver transplantation, and its typical clinical picture is characterized by hemolytic anemia, thrombocytopenia, renal dysfunction, neurological abnormalities, and fever. We report the case of a 56-year-old female with end-stage liver disease who underwent living donor liver transplantation (LDLT), and whose postoperative course was characterized by renal failure and progressive hyperbilirubinemia. Two weeks after LDLT, she started to show progressive thrombocytopenia, anemia, oliguria, and encephalopathy. From these clinical manifestations, she was diagnosed as having TMA and underwent plasma exchanges with continuous hemodialysis under temporary holding calcineurin inhibitors. The patient promptly responded to the treatment, with improved hematological, hepatic, and renal conditions, and was discharged from hospital a month later in a stable condition. We describe this case of TMA after LDLT with poor graft function and extensively review the disease in liver transplant recipients.
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U2 - 10.1007/s12328-013-0446-2
DO - 10.1007/s12328-013-0446-2
M3 - Article
C2 - 26183634
AN - SCOPUS:84900321664
VL - 7
SP - 159
EP - 163
JO - Clinical Journal of Gastroenterology
JF - Clinical Journal of Gastroenterology
SN - 1865-7257
IS - 2
ER -