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Successful living donor liver transplantation for severe hepatic GVHD histologically resembling autoimmune hepatitis after bone marrow transplantation from the same sibling donor
Authors:Minako Mori  Sumie Tabata  Hisako Hashimoto  Daichi Inoue  Takaharu Kimura  Sonoko Shimoji  Yuya Nagai  Katsuhiro Togami  Kiminari Itoh  Akiko Matsushita  Kenichi Nagai  Eiji Ikeda  Naoya Kimoto  Kenji Uryuhara  Satoru Kaihara  Yukihiro Imai  Masafumi Itoh  Takayuki Takahashi
Affiliation:1. Department of Hematology and Clinical Immunology, Kobe City Medical Center General Hospital, Kobe, Japan;2. Foundation for Biomedical Research and Innovation, Kobe, Japan;3. Foundation for Biomedical Research and Innovation, Kobe, Japan;4. Department of Gastroenterology, Kobe City Medical Center General Hospital, Kobe, Japan;5. Department of Transplantation, Kobe City Medical Center General Hospital, Kobe, Japan;6. Department of Clinical Pathology, Kobe City Medical Center General Hospital, Kobe, Japan;7. Division of Diagnostic Pathology, Japanese Red Cross Nagoya Daiichi Hospital, Nagoya, Japan
Abstract:A 30‐year‐old woman developed severe liver dysfunction 1 year after bone marrow transplantation (BMT) from an HLA‐identical sibling donor for B lymphoblastic leukemia (B‐ALL) during the tapering of cyclosporin A. The histologic picture resembled autoimmune hepatitis (AIH), although neither autoantibody nor hypergammaglobulinemia was detected. She entered hepatic coma, and underwent living donor liver transplantation from the same donor on day 421 after BMT. She is well 18 months after the procedure, showing normal liver function and hematopoiesis. AIH‐like hepatic graft‐versus‐host disease (GVHD) has not been documented. This patient is the second case of living donor liver transplantation for hepatic GVHD from the same donor.
Keywords:autoimmune hepatitis  bone marrow transplantation  hepatic graft‐versus‐host‐disease  living donor liver transplantation
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