Soyama Akihiko, Eguchi Susumu, Takatsuki Mitsuhisa, Ichikawa Tatsuki, Moriuchi Masako, Moriuchi Hiroyuki, Nakamura Tatsufumi, Tajima Yoshitsugu, Kanematsu Takashi
Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Liver Transpl. 2008 May;14(5):647-50. doi: 10.1002/lt.21414.
This report describes a patient who developed human T-cell leukemia virus type I-associated myelopathy (HAM) following a living-donor liver transplantation (LDLT) for liver cirrhosis due to hepatitis C virus (HCV) infection. Both the recipient and the living donor (his sister) were human T-cell leukemia virus type I (HTLV-I) carriers. Since the LDLT, he had been treated with immunosuppressive drugs such as tacrolimus and steroids as well as interferon-alpha to prevent rejection and a recurrence of the HCV infection, respectively. Even though the HTLV-I proviral load had decreased upon interferon treatment, he developed a slowly progressive gait disturbance with urinary disturbance 2 years after the LDLT and was diagnosed with HAM. This appears to be the first report of HAM development in an HLTV-I-infected LDLT recipient.
本报告描述了一名因丙型肝炎病毒(HCV)感染导致肝硬化而接受活体供肝肝移植(LDLT)后发生I型人类T细胞白血病病毒相关脊髓病(HAM)的患者。受者和活体供者(其妹妹)均为I型人类T细胞白血病病毒(HTLV-I)携带者。自LDLT术后,他分别接受了诸如他克莫司和类固醇等免疫抑制药物以及干扰素-α的治疗,以预防排斥反应和HCV感染复发。尽管干扰素治疗后HTLV-I前病毒载量有所下降,但他在LDLT术后2年出现了伴有排尿障碍的缓慢进展性步态障碍,并被诊断为HAM。这似乎是关于HTLV-I感染的LDLT受者发生HAM的首例报告。