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A Successful Liver Transplantation for Refractory Hepatic Veno-Occlusive Disease Originating from Cord Blood Transplantation

  1. Il-Deok Kim1,
  2. Hiroto Egawa1,
  3. Yuhji Marui1,
  4. Satoshi Kaihara2,
  5. Hironori Haga2,
  6. Ying-Wei Lin3,
  7. Kazuko Kudoh4,
  8. Tetsuya Kiuchi1,
  9. Shinji Uemoto2,
  10. Koichi Tanaka1,2,*

Article first published online: 28 AUG 2002

DOI: 10.1034/j.1600-6143.2002.20815.x

Issue

American Journal of Transplantation

American Journal of Transplantation

Volume 2, Issue 8, pages 796–800, September 2002

Additional Information

How to Cite

Kim, I.-D., Egawa, H., Marui, Y., Kaihara, S., Haga, H., Lin, Y.-W., Kudoh, K., Kiuchi, T., Uemoto, S. and Tanaka, K. (2002), A Successful Liver Transplantation for Refractory Hepatic Veno-Occlusive Disease Originating from Cord Blood Transplantation. American Journal of Transplantation, 2: 796–800. doi: 10.1034/j.1600-6143.2002.20815.x

Author Information

  1. 1

    Department of Transplantation and Immunology,

  2. 2

    Organ Transplantation Unit, and

  3. 3

    Department of Pediatrics, Kyoto University Hospital, Kyoto 606–8507, Japan

  4. 4

    Department of Pediatrics, Japanese Red Cross Nagoya First Hospital, Nagoya 453–8511, Japan

* *Corresponding author: Koichi Tanaka, lkoichi@kuhp.kyoto-u.ac.jp

Publication History

  1. Issue published online: 28 AUG 2002
  2. Article first published online: 28 AUG 2002
  3. Received 18 October 2001,revised andaccepted for publication 20 March 2002

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Keywords:

  • Cord blood transplantation;
  • liver transplantation;
  • veno-occlusive disease

An 11-month-old boy with acute lymphoblastic leukemia (ALL) underwent umbilical cord blood transplantation (CBT) from an unrelated donor after a first complete remission. Despite the prophylactic use of low molecular weight heparin, prostaglandin E1 and ursodeoxycholic acid, hepatic veno-occlusive disease (VOD) occurred on the 29th day after CBT. Furthermore, neither defibrotide nor antithrombin-III improved the hepatic coma and coagulopathy due to the hepatic VOD. On the 42nd day after CBT, he underwent living related liver transplantation (LRLT) with a left lateral segment graft from his father. He received tacrolimus for the prevention of rejection and graft-vs.-host disease (GVHD) and also received aggressive antifungal and antiviral prophylaxis. Although he showed signs of acute rejection on postoperative days 5 and 10, the postoperative course was uneventful in general. At present, 17 months after LRLT, the patient shows stable liver function and no signs of either GVHD or a relapse of ALL. In conclusion, LRLT can be seen as a feasible option for the treatment of a hepatic VOD after CBT, though aggressive prophylaxis for infection and the anticipation of acute rejection are of importance.

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