title: Parvovirus associated fulminant hepatic failure and aplastic anemia treated successfully with liver and bone marrow transplantation. A report of two cases.
abstract: Aplastic anemia (AA) has been observed in nearly a third of patients undergoing liver transplantation (LT) for non-A-E fulminant hepatic failure (FHF). Few of these patients have been successfully managed with sequential LT and bone marrow transplantation (BMT). No causative agent has been identified for the FHF or AA in these reported cases. At our center, two patients, aged 15 years and 7 years, respectively, underwent sequential living-related LT and living-unrelated BMT. These patients are 10/9 years and 5/4 years post-LT/BMT. Human parvovirus B19 (HPV-B19) was established as the causative agent for FHF in both these patients by polymerase chain reaction. This report presents the first two cases associating HPV-B19 with FHF and AA who underwent sequential LT and BMT with excellent outcomes.
authors.affiliation: Methodist Specialty and Transplant Hospital, San Antonio, TX.
authors.forename: L
authors.initials: L
authors.lastname: Bathla
authors.forename: W J
authors.initials: WJ
authors.lastname: Grant
authors.forename: D F
authors.initials: DF
authors.lastname: Mercer
authors.forename: L M
authors.initials: LM
authors.lastname: Vargas
authors.forename: C L
authors.initials: CL
authors.lastname: Gebhart
authors.forename: A N
authors.initials: AN
authors.lastname: Langnas
mesh_terms: D000293:Adolescent; D000741:Anemia, Aplastic / Q000601:surgery*; D001483:Base Sequence; D016026:Bone Marrow Transplantation; D002648:Child; D017931:DNA Primers; D004269:DNA, Bacterial / Q000235:genetics; D006801:Humans; D017114:Liver Failure, Acute / Q000601:surgery* / Q000821:virology; D016031:Liver Transplantation; D008297:Male; D016732:Parvovirus B19, Human / Q000235:genetics / Q000302:isolation & purification / Q000472:pathogenicity*
chemical_list: D017931:DNA Primers; D004269:DNA, Bacterial
keywords: Bone marrow/hematopoietic stem cell transplantation; clinical research/practice; fulminant hepatic failure; liver transplantation/hepatology; liver transplantation: living donor