title: Successful treatment of fibrosing cholestatic hepatitis following kidney transplantation with allogeneic hematopoietic stem cell transplantation: a case report.
abstract: Fibrosing cholestatic hepatitis (FCH) is an uncommon complication of renal transplantation and usually associated with hepatitis B and C viral infection. Without treatment, the prognosis is usually fatal within weeks of onset. There was rarely report with successful treatment intervention. This case report describes a uremic patient with HCV infection who developed a fatal form of FCH after kidney transplantation. This is the first reported successful case with allogeneic hematopoietic stem cell transplantation (AHSCT) without ablative conditioning. A dramatic virologic and clinical improvement was observed in this post-transplantation patient. But no adverse events related to AHSCT were observed. The patient returned to work full-time at 10 months of hospitalization and is still in good health by now. Serum HCV RNA gradually decreased from 2.5 × 10 (6) Copies/mL at day 1 to 3.2 × 10 (4) Copies/mL at day 98 and became negative (<400  Copies/mL) at day 126 of hospitalization and remains negative at the last available assessment. Our report suggests that allogeneic HSCT may have a therapeutic role in FCH.
authors: From the Department of Hepatobiliary Disease, Fuzhou General Hospital (Dongfang Hospital), Xiamen University, Fuzhou 350025, China (DLL, JF, ZW); Department of Pathology, Fuzhou General Hospital (Dongfang Hospital), Xiamen University, Fuzhou 350025, China (ZZ); Department of Urology, Fuzhou General Hospital (Dongfang Hospital), Xiamen University, Fuzhou 350025, China (WW).
authors: Dong Liang
authors: DL
authors: Li
authors: Jian
authors: J
authors: Fang
authors: Zhiyong
authors: Z
authors: Zheng
authors: Weizhen
authors: W
authors: Wu
authors: Zhixian
authors: Z
authors: Wu
mesh_terms: D002780:Cholestasis, Intrahepatic / Q000209:etiology* / Q000473:pathology / Q000628:therapy*; D005355:Fibrosis; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006526:Hepatitis C / Q000453:epidemiology; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged
chemical_list: D007166:Immunosuppressive Agents
references: Pediatr Transplant. 2002 Feb;6(1):63-8
references: 11906645
references: Hepatology. 2000 Jul;32(1):11-6
references: 10869283
references: Transplant Proc. 2001 Feb-Mar;33(1-2):71-6
references: 11266709
references: Gastroenterology. 1992 Mar;102(3):956-62
references: 1537531
references: Transplantation. 2006 Oct 15;82(7):853-6
references: 17038897
references: Hepatology. 1996 May;23(5):971-6
references: 8621177
references: Surg Forum. 1970;21:281-4
references: 4936984
references: Nature. 2000 Jul 20;406(6793):257
references: 10917519
references: Transplant Proc. 2003 Feb;35(1):203-6
references: 12591366
references: Liver Transpl. 2003 Feb;9(2):191-6
references: 12548514
references: Transplant Proc. 2000 Nov;32(7):2001-2
references: 11120039
references: Int Urol Nephrol. 2004;36(3):433-5
references: 15783120
references: Transplantation. 1998 Nov 15;66(9):1254-8
references: 9825826
references: N Engl J Med. 2008 Jan 24;358(4):353-61
references: 18216355
references: Hepatology. 1998 Jan;27(1):2-6
references: 9425909
references: Gastroenterology. 1992 Oct;103(4):1307-12
references: 1397890
references: Science. 1999 May 14;284(5417):1168-70
references: 10325227
references: Gastroenterology. 1997 Feb;112(2):575-82
references: 9024312
references: Transplantation. 1996 Oct 27;62(8):1149-60
references: 8900317
references: Transplantation. 1996 Feb 15;61(3):378-81
references: 8610344
references: J Gastroenterol Hepatol. 2002 Mar;17(3):345-50
references: 11982709
references: N Engl J Med. 2008 Jan 24;358(4):362-8
references: 18216356
references: Hepatology. 1991 Jan;13(1):150-7
references: 1988336
references: Transplantation. 1997 Jan 15;63(1):158-60
references: 9000679
references: Nat Med. 2000 Nov;6(11):1229-34
references: 11062533