Diagnosis and treatment of hepatic sinusoidal obstruction syndrome after liver transplantation: a single-center experience
10.3969/j.issn.1674-7445.2021.01.014
- VernacularTitle:肝移植术后肝窦阻塞综合征的单中心诊疗经验
- Author:
Ying LIU
1
;
Liying SUN
;
Zhijun ZHU
;
Lin WEI
;
Wei QU
;
Zhigui ZENG
;
Xinyan ZHAO
Author Information
1. Liver Transplantation Center, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
- Publication Type:Research Article
- Keywords:
Hepatic sinusoidal obstruction syndrome;
Liver transplantation;
Drug-induced liver injury;
Anticoagulant therapy;
Ascites;
Transjugular intrahepatic portosystemic shunt;
Tacrolimus;
Anticardiolipin antibody
- From:
Organ Transplantation
2021;12(1):90-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To summarize the incidence, diagnostic and therapeutic experience of hepatic sinusoidal obstruction syndrome (HSOS) after liver transplantation. Methods Clinical data of 4 patients with HSOS after liver transplantation were retrospectively analyzed. The incidence, clinical manifestations, imaging and pathological characteristics of HSOS after liver transplantation were collected, and the treatment methods and clinical outcomes of patients with HSOS were analyzed. Results The incidence of HSOS after liver transplantation was 0.8%(2/239), and the median time of onset was 4.5(1.7, 9.0) months after liver transplantation. The clinical manifestations of HSOS mainly included abdominal distension, ascites, hepatomegaly, increased bilirubin, and renal insufficiency in partial cases. Enhanced abdominal CT scan of 4 patients with HSOS showed uneven spot-like enhancement and the liver histopathological examination mainly showed the signs of hepatic sinusoidal dilatation complicated with congestion. Four patients were administered with an adjusted regime of immunosuppressant by replacing tacrolimus (Tac) with ciclosporin and adding anticoagulant therapy with warfarin. One patient received transjugular intrahepatic portosystemic shunt (TIPS). After treatment, the symptoms of 3 patients were completely relieved, and 1 patient died. One of the 3 surviving patients died from pulmonary infection and gastrointestinal bleeding. Conclusions HSOS is a rare and fatal complication after liver transplantation. Timely diagnosis and treatment can avoid the incidence of graft failure and improve clinical prognosis of the patients.
