Successful living donor liver transplantation for severe hepatic GVHD histologically resembling autoimmune hepatitis after bone marrow transplantation from the same sibling donor.
A 30-year-old woman developed severe liver dysfunction 1 year after bone marrow transplantation (BMT) from an HLA-identical sibling donor for B lymphoblastic leukemia (B-ALL) during the tapering of cyclosporin A. The histologic picture resembled autoimmune hepatitis (AIH), although neither autoantibody nor hypergammaglobulinemia was detected. She entered hepatic coma, and underwent living donor liver transplantation from the same donor on day 421 after BMT. She is well 18 months after the procedure, showing normal liver function and hematopoiesis. AIH-like hepatic graft-versus-host disease (GVHD) has not been documented. This patient is the second case of living donor liver transplantation for hepatic GVHD from the same donor.
Mori
Minako
M
Department of Hematology and Clinical Immunology, Kobe City Medical Center General Hospital, Kobe, Japan.
Tabata
Sumie
S
Hashimoto
Hisako
H
Inoue
Daichi
D
Kimura
Takaharu
T
Shimoji
Sonoko
S
Nagai
Yuya
Y
Togami
Katsuhiro
K
Itoh
Kiminari
K
Matsushita
Akiko
A
Nagai
Kenichi
K
Ikeda
Eiji
E
Kimoto
Naoya
N
Uryuhara
Kenji
K
Kaihara
Satoru
S
Imai
Yukihiro
Y
Itoh
Masafumi
M
Takahashi
Takayuki
T
D000328:Adult; D001706:Biopsy; D016026:Bone Marrow Transplantation / Q000379:methods*; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology* / Q000628:therapy; D006680:HLA Antigens / Q000737:chemistry; D006410:Hematopoiesis; D019693:Hepatitis, Autoimmune / Q000209:etiology / Q000276:immunology*; D006801:Humans; D006942:Hypergammaglobulinemia / Q000276:immunology; D016130:Immunophenotyping; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015456:Leukemia, Biphenotypic, Acute / Q000150:complications / Q000628:therapy; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors
D006680:HLA Antigens; D007166:Immunosuppressive Agents