title: Hemophagocytic syndrome after liver transplantation: report of two cases.
abstract: We report two cases of hemophagocytic syndrome (HPS), a rare but fatal complication after living-donor liver transplantation (LDLT). Despite their recovery from pancytopenia following treatment with steroid pulse therapy, granulocyte stimulating factor, and intravenous γ-globulin, both patients died. The outcomes reported in cases published in English are devastating, with only 4 survivors among the total 14 patients including ours. Pancytopenia is frequently recognized postoperatively in liver transplant recipients, although its cause is difficult to establish. When pancytopenia accompanying persistent high fever is recognized in LDLT recipients, HPS should be suspected and bone marrow aspiration performed as promptly as possible because of the poor prognosis of this syndrome. There is still no optimal treatment for HPS after liver transplantation.
authors.affiliation: Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Soyama
authors.forename: Susumu
authors.initials: S
authors.lastname: Eguchi
authors.forename: Mitsuhisa
authors.initials: M
authors.lastname: Takatsuki
authors.forename: Masaaki
authors.initials: M
authors.lastname: Hidaka
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Tomonaga
authors.forename: Kosho
authors.initials: K
authors.lastname: Yamanouchi
authors.forename: Kensuke
authors.initials: K
authors.lastname: Miyazaki
authors.forename: Takamitsu
authors.initials: T
authors.lastname: Inokuma
authors.forename: Yoshitsugu
authors.initials: Y
authors.lastname: Tajima
authors.forename: Takashi
authors.initials: T
authors.lastname: Kanematsu
mesh_terms: D001854:Bone Marrow Cells / Q000473:pathology; D018450:Disease Progression; D004359:Drug Therapy, Combination; D017809:Fatal Outcome; D006801:Humans; D017093:Liver Failure / Q000175:diagnosis / Q000601:surgery; D016031:Liver Transplantation / Q000009:adverse effects* / Q000379:methods; D019520:Living Donors; D051359:Lymphohistiocytosis, Hemophagocytic / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000503:physiopathology; D010198:Pancytopenia / Q000209:etiology / Q000628:therapy*; D011183:Postoperative Complications / Q000175:diagnosis / Q000188:drug therapy; D012720:Severity of Illness Index