A successful liver transplantation for refractory hepatic veno-occlusive disease originating from cord blood transplantation.
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| Abstract |
An 11-month-old boy with acute lymphoblastic leukemia (ALL) underwent umbilical cord blood transplantation (CBT) from an unrelated donor after a first complete remission. Despite the prophylactic use of low molecular weight heparin, prostaglandin E1 and ursodeoxycholic acid, hepatic veno-occlusive disease (VOD) occurred on the 29th day after CBT. Furthermore, neither defibrotide nor antithrombin-III improved the hepatic coma and coagulopathy due to the hepatic VOD. On the 42nd day after CBT, he underwent living related liver transplantation (LRLT) with a left lateral segment graft from his father. He received tacrolimus for the prevention of rejection and graft-vs.-host disease (GVHD) and also received aggressive antifungal and antiviral prophylaxis. Although he showed signs of acute rejection on postoperative days 5 and 10, the postoperative course was uneventful in general. At present, 17 months after LRLT, the patient shows stable liver function and no signs of either GVHD or a relapse of ALL. In conclusion, LRLT can be seen as a feasible option for the treatment of a hepatic VOD after CBT, though aggressive prophylaxis for infection and the anticipation of acute rejection are of importance.
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| Authors | Il-Deok Kim, Hiroto Egawa, Yuhji Marui, Satoshi Kaihara, Hironori Haga, Ying-Wei Lin, Kazuko Kudoh, Tetsuya Kiuchi, Shinji Uemoto, Koichi Tanaka |
| Journal | American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons (Am J Transplant) Vol. 2 Issue 8 Pg. 796-800 (Sep 2002) ISSN: 1600-6135 [Print] United States |
| PMID | 12243502 (Publication Type: Case Reports, Journal Article) |
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