Fibrosing cholestatic hepatitis developing within one month after living donor liver transplantation for chronic hepatitis c-related cirrhosis: A case report

K. Murakami, N. Kawagishi, K. Ishida, Satoshi Sekiguchi, F. Fujishima, H. Sasano, N. Ohuchi

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Fibrosing cholestatic hepatitis (FCH) is a life-threatening consequence of hepatitis C virus (HCV) infection occurring in a small minority of liver transplantation (LT) recipients. We herein report a case of early-onset FCH after living donor LT in a 47-year-old woman with HCV-related cirrhosis. The patient underwent balloon-occluded retrograde transvenous obliteration of a splenorenal shunt to treat an impaired portal flow on the sixth postoperative day (POD 6) and a bypass operation for hepatic artery thrombosis on POD 12. Thereafter, the serum bilirubin levels increased gradually; however, computed tomography revealed no evidence of biliary stricture. The serum HCV-RNA level on POD 27 was >7.8 log IU/mL. Histopathology of a needle graft biopsy performed on POD 28 revealed FCH with extensive portal fibrosis accompanied by mild inflammation, hepatocyte ballooning, and ductular proliferation with cholestasis. The patient received combination therapy with pegylated interferon, ribavirin, and double-filtration plasmapheresis for the treatment of early-onset FCH. Both the recipient and the donor carried the major genotype single nucleotide polymorphism (TT) at rs8099917 near the interleukin-28B gene. Furthermore, the HCV genotype was treatment-sensitive 2a. Nonetheless, the recipient died of hepatic failure on POD 211. Thus far, few cases of FCH occurring within 1 month after LT have been reported. In addition, the early onset of FCH may be an adverse prognostic factor.

Original languageEnglish
Pages (from-to)995-998
Number of pages4
JournalTransplantation Proceedings
Volume46
Issue number3
DOIs
Publication statusPublished - 2014 Apr

ASJC Scopus subject areas

  • Surgery
  • Transplantation

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