Thrombotic microangiopathy caused by severe graft dysfunction after living donor liver transplantation: report of a case

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• 作者：Daisuke Matsuda (1)
  Takeo Toshima (1)
  Toru Ikegami (1)
  Norifumi Harimoto (1)
  Yo-ichi Yamashita (1)
  Tomoharu Yoshizumi (1)
  Yuji Soejima (1)
  Tetsuo Ikeda (1)
  Ken Shirabe (1)
  Yoshihiko Maehara (1)
  
• 关键词：Living donor liver transplantation ; Thrombotic microangiopathy ; Graft dysfunction ; Plasma exchange
• 刊名：Clinical Journal of Gastroenterology
• 出版年：2014
• 出版时间：April 2014
• 年：2014
• 卷：7
• 期：2
• 页码：159-163
• 全文大小：474 KB
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  11. Ikegami T, Shirabe K, Yoshizumi T, Aishima S, Taketomi YA, Soejima Y, et al. Primary graft dysfunction after living donor liver transplantation is characterized by delayed functional hyperbilirubinemia. Am J Transplant. 2012;12:1886. CrossRef
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• 作者单位：Daisuke Matsuda (1)
  Takeo Toshima (1)
  Toru Ikegami (1)
  Norifumi Harimoto (1)
  Yo-ichi Yamashita (1)
  Tomoharu Yoshizumi (1)
  Yuji Soejima (1)
  Tetsuo Ikeda (1)
  Ken Shirabe (1)
  Yoshihiko Maehara (1)
  
  1. Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
  
• ISSN：1865-7265

文摘

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.