Liver transplantation in an adolescent with acute liver failure from acute lymphoblastic leukemia

Pediatr Transplant. 2014 Mar;18(2):E57-63. doi: 10.1111/petr.12221. Epub 2014 Jan 20.

Abstract

The most common identifiable causes of acute liver failure in pediatric patients are infection, drug toxicity, metabolic disease, and autoimmune processes. In many cases, the etiology of acute liver failure cannot be determined. Acute leukemia is an extremely rare cause of acute liver failure, and liver transplantation has traditionally been contraindicated in this setting. We report a case of acute liver failure in a previously healthy 15-yr-old male from pre-B-cell acute lymphoblastic leukemia. He underwent liver transplantation before the diagnosis was established, and has subsequently received chemotherapy for pre-B-cell acute lymphoblastic leukemia. He is currently alive 31 months post-transplantation. The published literature describing acute lymphoblastic leukemia as a cause of acute liver failure is reviewed.

Keywords: acute liver failure; adolescent; liver transplant; malignancy.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Biopsy
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Leukemia, B-Cell / complications*
  • Leukemia, B-Cell / therapy*
  • Liver / pathology
  • Liver Failure, Acute / complications*
  • Liver Failure, Acute / surgery*
  • Liver Function Tests
  • Liver Transplantation*
  • Male
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / complications*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / therapy*
  • Tissue Donors
  • Treatment Outcome

Substances

  • Immunosuppressive Agents