Udayasankar Madhumita, Rammohan Ashwin, Sathya A C, Rajakumar Akila, Rela Mohamed
The Institute of Liver Disease & Transplantation, Dr Rela Institute and Medical Centre, Chennai, IND.
Cureus. 2021 Jan 24;13(1):e12890. doi: 10.7759/cureus.12890.
Living donor liver transplantation is a complex surgery, where the donor's safety is of paramount importance. Despite all precautions, donor morbidity may be inevitable, and long-term follow-up data attest to this fact. However, being a "past donor" all ailments are intuitively attributed to the donation process, which may not always be the case. We present the case of a 47-year-old lady, who developed thrombotic thrombocytopenic purpura secondary to systemic lupus erythematosus 18 months following her liver donation, when she detected to be anti-nuclear antibody (ANA) positive. She developed neurological signs and was managed successfully with therapeutic plasma exchange and steroids. She was discharged home on immunosuppression and remains well on follow-up. We present the medical and social issues that were addressed in the case and highlight the need for a more stringent follow-up protocol in those who are ANA positive. This would also help detect morbidities that may be unrelated to the donation process.
活体肝移植是一项复杂的手术，供体的安全至关重要。尽管采取了所有预防措施，供体出现并发症仍可能不可避免，长期随访数据证实了这一事实。然而，作为一名“曾经的供体”，所有疾病都直观地归因于捐赠过程，但情况并非总是如此。我们报告一例47岁女性的病例，她在肝脏捐赠18个月后因系统性红斑狼疮继发血栓性血小板减少性紫癜，当时检测出抗核抗体（ANA）呈阳性。她出现了神经症状，并通过治疗性血浆置换和类固醇成功治疗。她出院时接受免疫抑制治疗，随访时情况良好。我们介绍了该病例中涉及的医疗和社会问题，并强调对ANA阳性者需要更严格的随访方案。这也将有助于发现可能与捐赠过程无关的并发症。
