Iron overload after pediatric liver transplantation: a case report.
Iron is an essential nutrient for living cells; however, an excessive accumulation of iron leads to organ damage and directly affects systemic immunity. Iron overload is clinically classified as hereditary or secondary. Most of secondary iron overload is caused by frequent blood transfusions because there is no active mechanism to excrete iron from the body. As recommended in various guidelines, chelation therapy is effective for reducing iron burden and improving organ function. There have been few reports on iron overload through blood transfusion during the perioperative period of liver transplantation. This report presents a case of iron overload due to repeated transfusions after pediatric liver transplantation managed by chelation therapy. The patient, an 11-month-old female with biliary atresia, underwent living donor liver transplantation. She revealed refractory anemia and required frequent blood transfusion. Both serum ferritin and transferrin saturation tended to increase after repeated transfusions, leading to secondary iron overload. Iron chelation therapy was started to prevent progression to organ failure and infection due to iron overload, and yielded a favorable outcome. It is crucial to consider the possibility of secondary iron overload and to achieve early detection and treatment to avoid progression to irreversible organ damage.
Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan; Department of Transplant Surgery, Jichi Medical University, Shimotsuke, Tochigi, Japan. Electronic address: wakiya1979@yahoo.co.jp.
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Wakiya
Department of Transplant Surgery, Jichi Medical University, Shimotsuke, Tochigi, Japan.
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Sanada
Department of Transplant Surgery, Jichi Medical University, Shimotsuke, Tochigi, Japan.
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Urahashi
Department of Transplant Surgery, Jichi Medical University, Shimotsuke, Tochigi, Japan.
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Ihara
Department of Transplant Surgery, Jichi Medical University, Shimotsuke, Tochigi, Japan.
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Yamada
Department of Transplant Surgery, Jichi Medical University, Shimotsuke, Tochigi, Japan.
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Okada
Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan.
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Toyoki
Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan.
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Hakamada
Department of Transplant Surgery, Jichi Medical University, Shimotsuke, Tochigi, Japan.
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Mizuta
D005260:Female; D006801:Humans; D007223:Infant; D019190:Iron Overload / Q000000981:diagnostic imaging / Q000209:etiology*; D016031:Liver Transplantation / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed