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Liver transplantation in a patient with S(beta)o-thalassemia
Simone C O Gilli1, Ilka F S Boin, Luiz Sergio Leonardi
1Departamento de Clínica Médica da Faculdade de Ciências Médicas of State University of Campinas, Campinas, São Paulo, Brazil.
Background:
Patients presenting sickle cell disease may develop different types of hepatic complications. Intrahepatic cholestasis is a potentially fatal complication of the disease, and sometimes the only possible solution is transplantation. Postoperative transfusion management has not yet been well established. In this report, we describe the transfusional program of a patient presenting sickle cell disease and intrahepatic cholestasis who underwent liver transplantation 2 years ago.
Methods:
Data were obtained from the chart and the blood bank records.
Results:
The liver transplantation was performed successfully. Despite mild allograft dysfunction 3 months after surgery, secondary to intrahepatic sickling, the patient has been doing well with the transfusional management adopted (sickle-cell hemoglobin <20%).
Conclusion:
Sickle cell disease should not be a criterion for exclusion from liver transplantation. Regular transfusion with monitoring of sickle-cell hemoglobin is a very important measure to minimize the risk of intrahepatic sickling and possible rejection.