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Successful cytokine treatment of aplastic anemia following living‐related orthotopic liver transplantation for non‐A, non‐B, non‐C hepatitis
Author(s) -
Sato Sumihiko,
Fuchinoue Shohei,
Abe Masahiro,
Kitajima Kumiko,
Tojimbara Tamotsu,
Nakajima Ichiro,
Agishi Tetsuzo,
Shiraga Hiroshi,
Ito Katsumi,
Takasaki Ken,
Hashimoto Etsuko,
Hayashi Naoaki,
Tanaka Koichi
Publication year - 1999
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1034/j.1399-0012.1999.130112.x
Subject(s) - medicine , pancytopenia , aplastic anemia , liver transplantation , transplantation , liver biopsy , gastroenterology , immunology , hepatitis , fulminant hepatitis , hepatitis c , bone marrow , biopsy
The relationship between aplastic anemia and viral hepatitis is well recognized, and such patients usually have a high mortality. We successfully treated a case of aplastic anemia following living‐related orthotopic liver transplantation (LROLT) for non‐A, non‐B, non‐C hepatitis.A 2‐yr‐old boy with fulminant hepatic failure from non‐A, non‐B, non‐C hepatitis received LROLT. Before transplantation, he had pancytopenia which was probably hepatitis associated, and viral suppression was suspected after bone marrow (BM) biopsy. After the transplantation, he developed progressive pancytopenia and a diagnosis of aplastic anemia was made via BM biopsy. With immunosuppressant agents (cyclosporine, methylprednisolone), cytokine therapy (granulocyte‐colony stimulating factor (G‐CSF), macrophage‐colony stimulating factor (M‐CSF), recombinant human erythropoietin (rhEPO)) was effectual and the patient recovered from pancytopenia. He was discharged from the hospital 57 d after the liver transplantation and remains well 1 yr after LROLT. Combined cytokine therapy with high doses of G‐CSF, M‐CSF and rhEPO appeared to be effective in the treatment of aplastic anemia following liver transplantation for non‐A, non‐B, non‐C hepatitis. Since M‐CSF activates macrophages, it may have contributed to the graft rejection. Careful consideration should be given to the use of high‐dose M‐CSF in liver transplant patients.