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Hemophagocytic syndrome after liver transplantation: Report of two cases

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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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Authors and Affiliations

  1. Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan

    Akihiko Soyama, Susumu Eguchi, Mitsuhisa Takatsuki, Masaaki Hidaka, Tetsuo Tomonaga, Kosho Yamanouchi, Kensuke Miyazaki, Takamitsu Inokuma, Yoshitsugu Tajima & Takashi Kanematsu

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  1. Akihiko Soyama
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  2. Susumu Eguchi
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  3. Mitsuhisa Takatsuki
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  4. Masaaki Hidaka
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  5. Tetsuo Tomonaga
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  6. Kosho Yamanouchi
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  7. Kensuke Miyazaki
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  8. Takamitsu Inokuma
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  9. Yoshitsugu Tajima
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  10. Takashi Kanematsu
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Soyama, A., Eguchi, S., Takatsuki, M. et al. Hemophagocytic syndrome after liver transplantation: Report of two cases. Surg Today 41, 1524–1530 (2011). https://doi.org/10.1007/s00595-010-4512-9

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  • DOI: https://doi.org/10.1007/s00595-010-4512-9

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