Akamatsu N, Sugawara Y, Tamura S, Matsui Y, Hasegawa K, Imamura H, Kokudo N, Makuuchi M
Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
Transplant Proc. 2006 Jun;38(5):1425-8. doi: 10.1016/j.transproceed.2006.02.089.
Hemophagocytic syndrome is a fatal complication after liver transplantation that is rarely reported. Among 260 adult patients who underwent living donor liver transplantation at our hospital, three cases (1%) were complicated with hemophagocytic syndrome. Intensive investigation revealed Aspergillus, cytomegalovirus, and hepatitis C virus as the most likely causative organisms in each patient. Despite the immediate initiation of anti-infectious treatment and supportive care, all patients died. When pancytopenia with possible underlying infectious disease is observed in liver transplant recipients, hemophagocytic syndrome should be suspected and bone marrow biopsy considered. The prognosis of hemophagocytic syndrome remains poor and further investigations are required to establish effective therapeutic options.
噬血细胞综合征是肝移植术后一种罕见报道的致命并发症。在我院接受活体肝移植的260例成年患者中，有3例（1%）并发噬血细胞综合征。深入调查显示，曲霉菌、巨细胞病毒和丙型肝炎病毒分别是每位患者最可能的致病微生物。尽管立即开始抗感染治疗和支持治疗，但所有患者均死亡。当肝移植受者出现全血细胞减少并伴有潜在感染性疾病时，应怀疑噬血细胞综合征并考虑进行骨髓活检。噬血细胞综合征的预后仍然很差，需要进一步研究以确定有效的治疗方案。
