Thrombotic microangiopathy caused by severe graft dysfunction after living donor liver transplantation: Report of a case

被引：3

作者：

Matsuda D. ^{[1
]}

Toshima T. ^{[1
]}

Ikegami T. ^{[1
]}

Harimoto N. ^{[1
]}

Yamashita Y.-I. ^{[1
]}

Yoshizumi T. ^{[1
]}

Soejima Y. ^{[1
]}

Ikeda T. ^{[1
]}

Shirabe K. ^{[1
]}

Maehara Y. ^{[1
]}

机构：

[1] Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka 812-8582, 3-1-1, Maidashi

来源：

Clinical Journal of Gastroenterology | 2014年 / 7卷 / 2期

关键词：

Graft dysfunction; Living donor liver transplantation; Plasma exchange; Thrombotic microangiopathy;

D O I：

10.1007/s12328-013-0446-2

中图分类号：

学科分类号：

摘要：

Thrombotic microangiopathy (TMA) is a life-threatening complication after transplantation including liver transplantation, and its typical clinical picture is characterized by hemolytic anemia, thrombocytopenia, renal dysfunction, neurological abnormalities, and fever. We report the case of a 56-year-old female with end-stage liver disease who underwent living donor liver transplantation (LDLT), and whose postoperative course was characterized by renal failure and progressive hyperbilirubinemia. Two weeks after LDLT, she started to show progressive thrombocytopenia, anemia, oliguria, and encephalopathy. From these clinical manifestations, she was diagnosed as having TMA and underwent plasma exchanges with continuous hemodialysis under temporary holding calcineurin inhibitors. The patient promptly responded to the treatment, with improved hematological, hepatic, and renal conditions, and was discharged from hospital a month later in a stable condition. We describe this case of TMA after LDLT with poor graft function and extensively review the disease in liver transplant recipients. © 2014 Springer.

引用

页码：159 / 163

页数：4

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