Chimerism and Tolerance in a Recipient of a Deceased-Donor Liver Transplant

Complete hematopoietic chimerism and tolerance to a liver allograft developed in a 9-year-old girl who received a liver transplant from a deceased male donor. Tolerance was preceded by a period of severe hemolysis, reflecting partial chimerism that was refractory to standard therapies. The hemolysis...

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Published inThe New England journal of medicine Vol. 358; no. 4; pp. 369 - 374
Main Authors Alexander, Stephen I, Smith, Neil, Smith, Arabella, Hu, Min, Verran, Deborah, Shun, Albert, Dorney, Stuart, Webster, Boyd, Shaw, Peter John, Lammi, Ahti, Stormon, Michael O
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LanguageEnglish
Published Boston, MA Massachusetts Medical Society 24.01.2008
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Abstract Complete hematopoietic chimerism and tolerance to a liver allograft developed in a 9-year-old girl who received a liver transplant from a deceased male donor. Tolerance was preceded by a period of severe hemolysis, reflecting partial chimerism that was refractory to standard therapies. The hemolysis resolved after the gradual withdrawal of all immunosuppressive therapy. Complete hematopoietic chimerism and tolerance to a liver allograft developed in a 9-year-old girl who received a liver transplant from a deceased male donor. Tolerance was preceded by a period of severe hemolysis, which resolved after the gradual withdrawal of all immunosuppressive therapy. Case Report Acute fulminant hepatitis after a nonspecific viral illness developed in a previously well 9-year-old girl. Her blood group was O, RhD-negative. She was referred to our institution, and at the time of admission she had markedly elevated aminotransferase levels and evidence of marked synthetic dysfunction (Table 1). Extensive testing ruled out known viral, metabolic, drug-related, and autoimmune causes, and a diagnosis of “non–A-to-G viral hepatitis” was made. A liver biopsy was not performed because of severe underlying coagulopathy. Given the patient's fulminant hepatic failure (Table 1) requiring mechanical ventilation, urgent liver transplantation was performed with the use of . . .
AbstractList Complete hematopoietic chimerism and tolerance of a liver allograft from a deceased male donor developed in a 9-year-old girl, with no evidence of graft-versus-host disease 17 months after transplantation. The tolerance was preceded by a period of severe hemolysis, reflecting partial chimerism that was refractory to standard therapies. The hemolysis resolved after the gradual withdrawal of all immunosuppressive therapy.
Complete hematopoietic chimerism and tolerance to a liver allograft developed in a 9-year-old girl who received a liver transplant from a deceased male donor. Tolerance was preceded by a period of severe hemolysis, reflecting partial chimerism that was refractory to standard therapies. The hemolysis resolved after the gradual withdrawal of all immunosuppressive therapy. Complete hematopoietic chimerism and tolerance to a liver allograft developed in a 9-year-old girl who received a liver transplant from a deceased male donor. Tolerance was preceded by a period of severe hemolysis, which resolved after the gradual withdrawal of all immunosuppressive therapy. Case Report Acute fulminant hepatitis after a nonspecific viral illness developed in a previously well 9-year-old girl. Her blood group was O, RhD-negative. She was referred to our institution, and at the time of admission she had markedly elevated aminotransferase levels and evidence of marked synthetic dysfunction (Table 1). Extensive testing ruled out known viral, metabolic, drug-related, and autoimmune causes, and a diagnosis of “non–A-to-G viral hepatitis” was made. A liver biopsy was not performed because of severe underlying coagulopathy. Given the patient's fulminant hepatic failure (Table 1) requiring mechanical ventilation, urgent liver transplantation was performed with the use of . . .
Author Webster, Boyd
Alexander, Stephen I
Hu, Min
Shaw, Peter John
Lammi, Ahti
Smith, Arabella
Stormon, Michael O
Smith, Neil
Dorney, Stuart
Shun, Albert
Verran, Deborah
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Issue 4
Keywords Human
Medicine
Treatment
Donor
Surgery
Liver
Tolerance
Graft
Recipient
Transplantation
Chimerism
Cadaver
Language English
License CC BY 4.0
Copyright 2008 Massachusetts Medical Society.
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Snippet Complete hematopoietic chimerism and tolerance to a liver allograft developed in a 9-year-old girl who received a liver transplant from a deceased male donor....
Complete hematopoietic chimerism and tolerance of a liver allograft from a deceased male donor developed in a 9-year-old girl, with no evidence of...
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SubjectTerms Biological and medical sciences
Child
Female
General aspects
Graft vs Host Disease
Hemolysis - immunology
Humans
Immunosuppression
Liver Failure, Acute - surgery
Liver Transplantation - immunology
Medical sciences
T-Lymphocytes - immunology
Transplantation Chimera - immunology
Transplantation Tolerance - genetics
Transplantation Tolerance - immunology
Transplantation, Homologous
Title Chimerism and Tolerance in a Recipient of a Deceased-Donor Liver Transplant
URI http://dx.doi.org/10.1056/NEJMoa0707255
https://www.ncbi.nlm.nih.gov/pubmed/18216357
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Volume 358
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