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Hemophagocytic syndrome after liver transplantation: Report of two cases
Authors:Akihiko Soyama  Susumu Eguchi  Mitsuhisa Takatsuki  Masaaki Hidaka  Tetsuo Tomonaga  Kosho Yamanouchi  Kensuke Miyazaki  Takamitsu Inokuma  Yoshitsugu Tajima  Takashi Kanematsu
Affiliation:(1) State Key Laboratory for Liver Research, The University of Hong Kong, 102 Pokfulam Road, Hong Kong, China;(2) Department of Surgery, The University of Hong Kong, Hong Kong, China;(3) Department of Medicine, The University of Hong Kong, Hong Kong, China;
Abstract:
We report two cases of hemophagocytic syndrome (HPS), a rare but fatal complication after living-donor liver transplantation (LDLT). Despite their recovery from pancytopenia following treatment with steroid pulse therapy, granulocyte stimulating factor, and intravenous γ-globulin, both patients died. The outcomes reported in cases published in English are devastating, with only 4 survivors among the total 14 patients including ours. Pancytopenia is frequently recognized postoperatively in liver transplant recipients, although its cause is difficult to establish. When pancytopenia accompanying persistent high fever is recognized in LDLT recipients, HPS should be suspected and bone marrow aspiration performed as promptly as possible because of the poor prognosis of this syndrome. There is still no optimal treatment for HPS after liver transplantation.
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