• Akihiko Soyama, Susumu Eguchi, Mitsuhisa Takatsuki, Masaaki Hidaka, Tetsuo Tomonaga, Kosho Yamanouchi, Kensuke Miyazaki, Takamitsu Inokuma, Yoshitsugu Tajima, and Takashi Kanematsu.
• Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
• Surg. Today. 2011 Nov 1;41(11):1524-30.

AbstractWe report two cases of hemophagocytic syndrome (HPS), a rare but fatal complication after living-donor liver transplantation (LDLT). Despite their recovery from pancytopenia following treatment with steroid pulse therapy, granulocyte stimulating factor, and intravenous γ-globulin, both patients died. The outcomes reported in cases published in English are devastating, with only 4 survivors among the total 14 patients including ours. Pancytopenia is frequently recognized postoperatively in liver transplant recipients, although its cause is difficult to establish. When pancytopenia accompanying persistent high fever is recognized in LDLT recipients, HPS should be suspected and bone marrow aspiration performed as promptly as possible because of the poor prognosis of this syndrome. There is still no optimal treatment for HPS after liver transplantation.

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