Sequential liver and haematopoietic stem cell transplantation in a case of fulminant hepatitis associated liver failure and aplastic anaemia

Eur J Haematol. 2019 Apr;102(4):375-377. doi: 10.1111/ejh.13213. Epub 2019 Feb 15.

Abstract

The management of severe aplastic anaemia is particularly challenging when it occurs in the context of recent liver transplantation. Rapid identification of a suitable donor followed by allogeneic haematopoietic stem cell transplantation is the only curative option. This scenario is often complicated by potentially life-threatening infections that develop as a consequence of immunosuppression. Alternative donor transplantation using suitably matched unrelated donors can be potentially life-saving when suitably matched sibling donors are unavailable. Above all, a dedicated interdisciplinary approach with seamless communication between hepatology, transplant surgery, haematology, and stem cell transplant services is essential to achieving optimal outcomes. Herein, we describe a case of severe hepatitis leading to hepatic failure who was treated with liver transplantation from a deceased donor, and later received an allogeneic haematopoietic stem cell transplantation from a matched unrelated donor for hepatitis-associated aplastic anaemia.

Keywords: allogeneic blood and marrow transplantation; aplastic anaemia; liver transplantation.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Anemia, Aplastic / diagnosis
  • Anemia, Aplastic / therapy*
  • Biomarkers
  • Diagnostic Imaging
  • Female
  • Graft vs Host Disease / etiology
  • Graft vs Host Disease / prevention & control
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Liver Failure, Acute / complications
  • Liver Failure, Acute / diagnosis
  • Liver Failure, Acute / therapy*
  • Liver Transplantation*
  • Male
  • Transplantation, Homologous
  • Young Adult

Substances

  • Biomarkers