Acute cellular rejection and its sequelae developing in a 42-year-old man after liver transplantation
✍ Scribed by M. Isabel Fiel; Thomas Schiano
- Publisher
- John Wiley and Sons
- Year
- 2009
- Tongue
- English
- Weight
- 449 KB
- Volume
- 50
- Category
- Article
- ISSN
- 0270-9139
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✦ Synopsis
A 42-year-old man with alcoholic liver disease underwent successful liver transplantation (LT) using a deceased donor. Both patient and donor were negative for antibody to cytomegalovirus (CMV), and the initial post-LT course was uneventful. Immuno-suppression consisted of interleukin-2 antagonist induction as well as tacrolimus, mycophenolate mofetil, and corticosteroids. Corticosteroids were discontinued by month 3 and tacrolimus levels were maintained between 10-15 ng/mL, with infection prophylaxis discontinued 3 months after LT. Following an episode of viral gastroenteritis, the patient became jaundiced with the following laboratory values: alanine aminotransferase 980 U/L, aspartate aminotransferase 810 U/L, alkaline phosphatase 390 U/L, and total bilirubin 15.8 mg/dL. Viral serologies were negative. Abdominal imaging showed no biliary or vascular abnormalities and a liver biopsy was performed that demonstrated severe acute cellular rejection.