TY - JOUR
T1 - Management of hepatic vein occlusive disease after liver transplantation
T2 - A case report with literature review
AU - Hou, Yuchen
AU - Tam, Nga Lei
AU - Xue, Zhicheng
AU - Zhang, Xuzhi
AU - Liao, Bing
AU - Yang, Jie
AU - Fu, Shunjun
AU - Ma, Yi
AU - Wu, Linwei
AU - He, Xiaoshun
N1 - Funding Information:
This study was supported by the National Nature Foundation of China (grant 81670592); The Nature Science Foundation of Guangdong Province, China (grant 2016A030313242); The Medical Scientific Research Foundation of Guangdong Province China (grant A2016033); The Science and Technology Program of Guangzhou, China (grant 201804020075); the Fundamental Research Funds for the Central Universities (grant 17ykjc9); and the Ke Lin programme foundation for youth talents (y50181).
Funding Information:
Both YH and NLT contributed equally to this work. Funding/support: This study was supported by the National Nature Foundation of China (grant 81670592); The Nature Science Foundation of Guangdong Province, China (grant 2016A030313242); The Medical Scientific Research Foundation of Guangdong Province China (grant A2016033); The Science and Technology Program of Guangzhou, China (grant 201804020075); the Fundamental Research Funds for the Central Universities (grant 17ykjc9); and the Ke Lin programme foundation for youth talents (y50181). We declare that we have no financial and personal relationships with other people or organizations that can inappropriately influence our work, there is no professional or other personal interest of any nature or kind in any product, service, and/or company that could be construed as influencing the position presented in, or the review of, the manuscript. aDepartment of Organ Transplantation, bDepartment of Pathology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. ∗Correspondence: Linwei Wu, and Xiaoshun He, Organ Transplant Center, First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan Er Road, Guangzhou 510080, China (e-mails: [email protected], [email protected]). Copyright © 2018 the Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal.
Publisher Copyright:
Copyright © 2018 the Author(s). Published by Wolters Kluwer Health, Inc.
PY - 2018/6
Y1 - 2018/6
N2 - Rationale: Hepatic vein occlusive disease (HVOD) is a rare complication after liver transplantation, which is characterized by nonthrombotic, fibrous obliteration of the small centrilobular hepatic veins by connective tissue and centrilobular necrosis in zone 3 of the acini. HVOD after solid organ transplantation has been reported; recently, most of these reports with limited cases have documented that acute cell rejection and immunosuppressive agents are the major causative factors. HVOD is relatively a rare complication of liver transplantation with the incidence of approximately 2%. Patient concerns: A 59-year-old male patient with alcoholic liver cirrhosis underwent liver transplantation in our center. He suffered ascites, renal impairment 3 months after the surgery while liver enzymes were in normal range. Diagnoses: Imagining and pathology showed no evidence of rejection or vessels complications. HVOD was diagnosed with pathology biopsy. Interventions: Tacrolimus was withdrawn and the progression of HVOD was reversed. Outcomes: Now, this patient has been followed up for 6 months after discharge with normal liver graft function. Lessons: The use of tacrolimus in patients after liver transplantation may cause HVOD. Patients with jaundice, body weight gain, and refractory ascites should be strongly suspected of tacrolimus related HVOD.
AB - Rationale: Hepatic vein occlusive disease (HVOD) is a rare complication after liver transplantation, which is characterized by nonthrombotic, fibrous obliteration of the small centrilobular hepatic veins by connective tissue and centrilobular necrosis in zone 3 of the acini. HVOD after solid organ transplantation has been reported; recently, most of these reports with limited cases have documented that acute cell rejection and immunosuppressive agents are the major causative factors. HVOD is relatively a rare complication of liver transplantation with the incidence of approximately 2%. Patient concerns: A 59-year-old male patient with alcoholic liver cirrhosis underwent liver transplantation in our center. He suffered ascites, renal impairment 3 months after the surgery while liver enzymes were in normal range. Diagnoses: Imagining and pathology showed no evidence of rejection or vessels complications. HVOD was diagnosed with pathology biopsy. Interventions: Tacrolimus was withdrawn and the progression of HVOD was reversed. Outcomes: Now, this patient has been followed up for 6 months after discharge with normal liver graft function. Lessons: The use of tacrolimus in patients after liver transplantation may cause HVOD. Patients with jaundice, body weight gain, and refractory ascites should be strongly suspected of tacrolimus related HVOD.
KW - Alcoholic liver cirrhosis
KW - Complication
KW - HVOD
KW - Liver transplantation
KW - Tacrolimus
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U2 - 10.1097/MD.0000000000011076
DO - 10.1097/MD.0000000000011076
M3 - Review article
C2 - 29901618
AN - SCOPUS:85049403643
SN - 0025-7974
VL - 97
JO - Medicine (United States)
JF - Medicine (United States)
IS - 24
M1 - e1076
ER -