title: Refractory Ascites with Liver Fibrosis Developed in Late Phase Allogeneic Hematopoietic Stem Cell Transplantation: Report of Three Patients.
abstract: We report cases of three patients of refractory ascites without other fluid retention that occurred around five months after allogeneic hematopoietic stem cell transplantation (allo-HSCT). All three patients expired and postmortem examinations revealed unexpected liver fibrosis lacking histological evidences of graft-versus-host-disease (GVHD). The three patients showed normal hepatic function and size before transplantation. During their clinical courses, serum biochemistry test showed no elevation of hepatic enzymes and bilirubin; however, imaging studies demonstrated hepatic atrophy at the onset of ascites. One of the liver specimens showed bile obstruction, which could be seen in hepatic damage by GVHD. Although ascites resulting from venoocclusive disease in early phase allo-HSCT is well documented, ascites associated with hepatic fibrosis in late phase allo-HCST has not been reported. Further clinico-pathological studies on similar patients should be required to ascertain refractory ascites associated with liver fibrosis after allo-HSCT.
authors: Department of Hematology and Oncology, Wakayama Medical University , Wakayama, Japan.
authors: Hiroki
authors: H
authors: Hosoi
authors: Department of Human Pathology and Diagnostic Pathology, Wakayama Medical University , Wakayama, Japan.
authors: Kenji
authors: K
authors: Warigaya
authors: Department of Hematology and Oncology, Wakayama Medical University , Wakayama, Japan.
authors: Shogo
authors: S
authors: Murata
authors: Department of Hematology and Oncology, Wakayama Medical University , Wakayama, Japan.
authors: Toshiki
authors: T
authors: Mushino
authors: Department of Hematology and Oncology, Wakayama Medical University , Wakayama, Japan.
authors: Kodai
authors: K
authors: Kuriyama
authors: Department of Hematology and Oncology, Wakayama Medical University , Wakayama, Japan.
authors: Akinori
authors: A
authors: Nishikawa
authors: Department of Hematology and Oncology, Wakayama Medical University , Wakayama, Japan.
authors: Shinobu
authors: S
authors: Tamura
authors: Department of Hematology and Oncology, Wakayama Medical University , Wakayama, Japan.
authors: Kazuo
authors: K
authors: Hatanaka
authors: Department of Hematology and Oncology, Wakayama Medical University , Wakayama, Japan.
authors: Nobuyoshi
authors: N
authors: Hanaoka
authors: First Department of Pathology, Wakayama Medical University , Wakayama, Japan.
authors: Yasuteru
authors: Y
authors: Muragaki
authors: Department of Human Pathology and Diagnostic Pathology, Wakayama Medical University , Wakayama, Japan.
authors: Shinichi
authors: S
authors: Murata
authors: Department of Hematology and Oncology, Wakayama Medical University , Wakayama, Japan.
authors: Hideki
authors: H
authors: Nakakuma
authors: Department of Hematology and Oncology, Wakayama Medical University , Wakayama, Japan.
authors: Takashi
authors: T
authors: Sonoki
keywords: Allo-hematopoietic stem cell transplantation; complications; liver fibrosis