title: Hemophagocytic syndrome after adult-to-adult living donor liver transplantation.
abstract: Hemophagocytic syndrome is a fatal complication after liver transplantation that is rarely reported. Among 260 adult patients who underwent living donor liver transplantation at our hospital, three cases (1%) were complicated with hemophagocytic syndrome. Intensive investigation revealed Aspergillus, cytomegalovirus, and hepatitis C virus as the most likely causative organisms in each patient. Despite the immediate initiation of anti-infectious treatment and supportive care, all patients died. When pancytopenia with possible underlying infectious disease is observed in liver transplant recipients, hemophagocytic syndrome should be suspected and bone marrow biopsy considered. The prognosis of hemophagocytic syndrome remains poor and further investigations are required to establish effective therapeutic options.
authors.affiliation: Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Akamatsu
authors.forename: Y
authors.initials: Y
authors.lastname: Sugawara
authors.forename: S
authors.initials: S
authors.lastname: Tamura
authors.forename: Y
authors.initials: Y
authors.lastname: Matsui
authors.forename: K
authors.initials: K
authors.lastname: Hasegawa
authors.forename: H
authors.initials: H
authors.lastname: Imamura
authors.forename: N
authors.initials: N
authors.lastname: Kokudo
authors.forename: M
authors.initials: M
authors.lastname: Makuuchi
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects; D006526:Hepatitis C / Q000601:surgery; D006801:Humans; D008103:Liver Cirrhosis / Q000601:surgery; D016031:Liver Transplantation / Q000009:adverse effects*; D019520:Living Donors; D051359:Lymphohistiocytosis, Hemophagocytic / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D020858:Tissue and Organ Harvesting / Q000009:adverse effects; D016896:Treatment Outcome