title: Progressive Multifocal Leukoencephalopathy after Three Consecutive Liver Transplantations.
abstract: Progressive multifocal leukoencephalopathy (PML) is a lytic infection of the central nervous system caused by the reactivation of John Cunningham Virus (JCV) in severely immunosuppressed patients. Occurrence of PML after solid organ transplantations, especially after liver transplantation, is rare. If a patient has poor prognostic factors such as atypical radiological involvements or high viral load in cerebrospinal fluid (CSF), overall survival rates could be poor. Herein, we report on a patients who underwent liver transplantation three times and developed PML with unexpected radiological findings; he was also positive for JCV DNA with a high viral load. Although there are limited data about efficacy of cytarabine against JCV, it was given to the patient for five days. Despite the initiation of cytarabine and complete cessation of the immunosuppressive therapy, we lost the patient, unfortunately.
authors: Inonu University, Liver Transplantation Institute, Department of General Surgery, Malatya, Turkey.
authors: F
authors: F
authors: Ozdemir
authors: Inonu University, Liver Transplantation Institute, Department of General Surgery, Malatya, Turkey.
authors: V
authors: V
authors: Ince
authors: Inonu University, Liver Transplantation Institute, Department of General Surgery, Malatya, Turkey.
authors: A
authors: A
authors: Baskiran
authors: Inonu University, Liver Transplantation Institute, Department of Radiology, Malatya, Turkey.
authors: Z
authors: Z
authors: Ozdemir
authors: Inonu University, Liver Transplantation Institute, Department of Infectious Diseases, Malatya, Turkey.
authors: Y
authors: Y
authors: Bayindir
authors: Inonu University, Faculty of Medicine, Department of Medical Microbiology, Malatya, Turkey.
authors: B
authors: B
authors: Otlu
authors: Inonu University, Liver Transplantation Institute, Department of General Surgery, Malatya, Turkey.
authors: S
authors: S
authors: Yilmaz
keywords: Immunocompromised host; JC virus; Leukoencephalopathy; Liver transplantation; Viral load; progressive multifocal