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Second Case of Deceased Donor Liver Transplantation in a Patient Co-infected with HIV and HCV in Japan : Special Reference to the Management of Complicated Coagulopathy Due to a Diverse Spectrum of Preformed Anti-HLA Antibodies

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Title: Second Case of Deceased Donor Liver Transplantation in a Patient Co-infected with HIV and HCV in Japan : Special Reference to the Management of Complicated Coagulopathy Due to a Diverse Spectrum of Preformed Anti-HLA Antibodies
Authors: Kawamura, Norio Browse this author →KAKEN DB
Goto, Ryoichi Browse this author →KAKEN DB
Koshizuka, Yasuyuki Browse this author
Watanabe, Masaaki Browse this author →KAKEN DB
Suzuki, Tomomi Browse this author →KAKEN DB
Endo, Tomoyuki Browse this author
Kondo, Takeshi Browse this author
Taketomi, Akinobu Browse this author →KAKEN DB
Shimamura, Tsuyoshi Browse this author →KAKEN DB
Issue Date: Sep-2020
Publisher: 国立感染症研究所(National Institute of Infectious Diseases, Japan)
Journal Title: Japanese journal of infectious diseases
Volume: 73
Issue: 5
Start Page: 369
End Page: 372
Publisher DOI: 10.7883/yoken.JJID.2019.487
Abstract: We report the second case of deceased donor liver transplantation in a patient co-infected with human immunodeficiency virus (HIV) and hepatitis C virus (HCV) in Japan. A 48-year-old patient with hemophilia A was infected with HIV and HCV through contaminated factor VIII concentrate in his childhood and developed cirrhosis and hepatocellular carcinoma. The patient was on the transplant list for a deceased donor liver. The patient had broad spectrum anti-HLA class I and II antibodies, which may be attributed to repeated whole blood transfusions in the past. Catastrophic coagulopathy during the surgery was predicted because of the underlying hemophilic status and severe thrombocytopenia requiring HLA-matched platelet products, which are difficult to obtain quickly. To maintain adequate platelet counts (> 5 x 10(4)/mu L) while awaiting liver transplantation, a thrombopoietin receptor agonist and rituximab were administered. During surgery, factor VIII concentrate was administered according to a previously planned protocol. Adequate hemostasis was obtained, and the operation was completed without uncontrollable coagulopathy. The postoperative course was uneventful, and the patient was discharged on postoperative day 41. Detailed planning is required for surgical patients with hemophilia and HIV/HCV cirrhosis, especially for those with a diverse spectrum of anti-HLA antibodies.
Type: article
URI: http://hdl.handle.net/2115/80437
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

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