Hemophagocytic syndrome after living donor liver transplantation: a case report with a review of the literature
Abstract Background Hemophagocytic syndrome (HPS) is a rare and potentially fatal complication following liver transplantation. Case presentation A 63-year-old woman with decompensated liver cirrhosis secondary to hepatitis B virus infection underwent living donor liver transplantation using the rig...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2018-08-01
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| Series: | Surgical Case Reports |
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| Online Access: | http://link.springer.com/article/10.1186/s40792-018-0505-5 |
| _version_ | 1811315686164660224 |
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| author | Norifumi Iseda Tomoharu Yoshizumi Takeo Toshima Akinari Morinaga Takahiro Tomiyama Junichi Takahashi Takashi Motomura Yohei Mano Shinji Itoh Noboru Harada Toru Ikegami Yuji Soejima |
| author_facet | Norifumi Iseda Tomoharu Yoshizumi Takeo Toshima Akinari Morinaga Takahiro Tomiyama Junichi Takahashi Takashi Motomura Yohei Mano Shinji Itoh Noboru Harada Toru Ikegami Yuji Soejima |
| author_sort | Norifumi Iseda |
| collection | DOAJ |
| description | Abstract Background Hemophagocytic syndrome (HPS) is a rare and potentially fatal complication following liver transplantation. Case presentation 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. Conclusions 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 small-for-size syndrome. Further studies of the mechanism of hypercytokinemia-induced HPS are required to confirm the optimal treatment for HPS. |
| first_indexed | 2024-04-13T11:35:25Z |
| format | Article |
| id | doaj.art-a516d9d2c6f44b178f0ef3ec0a0704f1 |
| institution | Directory Open Access Journal |
| issn | 2198-7793 |
| language | English |
| last_indexed | 2024-04-13T11:35:25Z |
| publishDate | 2018-08-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Surgical Case Reports |
| spelling | doaj.art-a516d9d2c6f44b178f0ef3ec0a0704f12022-12-22T02:48:28ZengSpringerOpenSurgical Case Reports2198-77932018-08-01411510.1186/s40792-018-0505-5Hemophagocytic syndrome after living donor liver transplantation: a case report with a review of the literatureNorifumi Iseda0Tomoharu Yoshizumi1Takeo Toshima2Akinari Morinaga3Takahiro Tomiyama4Junichi Takahashi5Takashi Motomura6Yohei Mano7Shinji Itoh8Noboru Harada9Toru Ikegami10Yuji Soejima11Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu UniversityDepartment of Surgery and Science, Graduate School of Medical Sciences, Kyushu UniversityDepartment of Surgery and Science, Graduate School of Medical Sciences, Kyushu UniversityDepartment of Surgery and Science, Graduate School of Medical Sciences, Kyushu UniversityDepartment of Surgery and Science, Graduate School of Medical Sciences, Kyushu UniversityDepartment of Surgery and Science, Graduate School of Medical Sciences, Kyushu UniversityDepartment of Surgery and Science, Graduate School of Medical Sciences, Kyushu UniversityDepartment of Surgery and Science, Graduate School of Medical Sciences, Kyushu UniversityDepartment of Surgery and Science, Graduate School of Medical Sciences, Kyushu UniversityDepartment of Surgery and Science, Graduate School of Medical Sciences, Kyushu UniversityDepartment of Surgery and Science, Graduate School of Medical Sciences, Kyushu UniversityDepartment of Surgery and Science, Graduate School of Medical Sciences, Kyushu UniversityAbstract Background Hemophagocytic syndrome (HPS) is a rare and potentially fatal complication following liver transplantation. Case presentation 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. Conclusions 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 small-for-size syndrome. Further studies of the mechanism of hypercytokinemia-induced HPS are required to confirm the optimal treatment for HPS.http://link.springer.com/article/10.1186/s40792-018-0505-5Hemophagocytic syndromeLiver transplantationSmall-for-size syndrome |
| spellingShingle | Norifumi Iseda Tomoharu Yoshizumi Takeo Toshima Akinari Morinaga Takahiro Tomiyama Junichi Takahashi Takashi Motomura Yohei Mano Shinji Itoh Noboru Harada Toru Ikegami Yuji Soejima Hemophagocytic syndrome after living donor liver transplantation: a case report with a review of the literature Surgical Case Reports Hemophagocytic syndrome Liver transplantation Small-for-size syndrome |
| title | Hemophagocytic syndrome after living donor liver transplantation: a case report with a review of the literature |
| title_full | Hemophagocytic syndrome after living donor liver transplantation: a case report with a review of the literature |
| title_fullStr | Hemophagocytic syndrome after living donor liver transplantation: a case report with a review of the literature |
| title_full_unstemmed | Hemophagocytic syndrome after living donor liver transplantation: a case report with a review of the literature |
| title_short | Hemophagocytic syndrome after living donor liver transplantation: a case report with a review of the literature |
| title_sort | hemophagocytic syndrome after living donor liver transplantation a case report with a review of the literature |
| topic | Hemophagocytic syndrome Liver transplantation Small-for-size syndrome |
| url | http://link.springer.com/article/10.1186/s40792-018-0505-5 |
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