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Title of Journal: Clin J Gastroenterol

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Abbravation: Clinical Journal of Gastroenterology

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Springer Japan

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1865-7265

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Complete response to posttransplant lymphoprolife

Authors: Koichiro Haruki Hiroaki Shiba Junichi Shimada Norimitsu Okui Tomonori Iida Katsuhiko Yanaga
Publish Date: 2016/10/31
Volume: 10, Issue: 1, Pages: 47-51
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Abstract

Posttransplant lymphoproliferative disorder PTLD is a lifethreatening complication of solid organ transplantation We herein report a case of PTLD after livingdonor liver retransplantation reLDLT for recurrent primary sclerosing cholangitis PSC for which complete response was achieved by surgical resection and rituximab A 47yearold man who had undergone livingdonor liver transplantation LDLT twice at age of 43 and 45 years for endstage liver disease firstly for PSC and secondary for recurrent PSC suffered liver dysfunction due to an acute cellular rejection ACR 17 months after reLDLT At reLDLT a right liver lobe was donated from his spouse Although steroid was effective for ACR PTLD developed in the ileocecal area The patient received rituximab for treatment of PTLD and ileocecal resection for hemorrhage from ileocecal PTLD The patient achieved complete response by rituximab and surgical resection for PTLD but PSC recurred and hemophagocytic syndrome HPS developed with hyperbilirubinemia and elevated serum ferritin The patient received steroid treatment for HPS but thrombocytopenia and coagulopathy developed presumably due to thrombotic microangiopathy Therefore tacrolimus was switched to mycophenolate mofetil Despite intensive treatment including plasmapheresis and platelet infusion fungal infection of both lungs developed and the patient died 22 months after reLDLT Autopsy revealed complete response of PTLD recurrence of PSC and persistance of HPS


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  1. A fatal case of progressive steatohepatitis, possibly chemotherapy-associated steatohepatitis related to gemcitabine
  2. Extensive 0-IIc (undifferentiated carcinoma) lesion around a gastric adenoma: a case report
  3. Hepatocellular carcinoma with gastric metastasis treated by simultaneous hepatic and gastric resection: report of a case
  4. A case of peripancreatic tuberculous lymphadenitis diagnosed by endoscopic ultrasound-guided fine-needle aspiration
  5. Perineurioma in the sigmoid colon diagnosed and treated by endoscopic resection
  6. Long-term surviving patient with inferior vena cava tumor thrombus and extrahepatic metastasis after spontaneous ruptured hepatocellular carcinoma
  7. Dysfunction of a port-catheter system percutaneously implanted for hepatic arterial infusion chemotherapy due to a fibrin sheath
  8. Novel findings of capsule endoscopy and double-balloon enteroscopy in a case of eosinophilic gastroenteritis
  9. Hypocalcemia secondary to hypomagnesemia in a patient with Crohn’s disease
  10. Successfully treated intractable pruritus with rifampin in a case of benign recurrent intrahepatic cholestasis
  11. First case of bacteremia caused by Helicobacter cinaedi in a patient with liver cirrhosis: a case report and literature review
  12. Diagnosis of pancreatic tuberculosis by combined, contrast-enhanced sonography and endoscopic ultrasound-guided fine-needle aspiration
  13. A case report of segmental arterial mediolysis in which computed tomography angiography was useful for diagnosis
  14. Impacted foreign body in the sigmoid colon presenting as recurrent diverticulitis
  15. A rare ring-shaped anomaly of the main pancreatic duct accompanying a branch duct IPMN
  16. Small intestinal perforation caused by cytomegalovirus reactivation after subtotal colectomy for ulcerative colitis: report of a case

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