Graft rejection occurring in post-liver transplant patients receiving cytotoxic chemotherapy: A case series

Hui Hui Tan, M. Isabel Fiel, Juan del Rio Martin, Thomas D. Schiano

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Liver transplant recipients are known to be at increased risk for the development of de novo neoplasms or the recurrence of preexisting malignancies, and this is possibly related to the use of immunosuppressive medication. Little is known about the effects of cytotoxic chemotherapy on graft function after transplantation. A retrospective chart and pathology database review was undertaken to identify post-liver transplant patients developing rejection during chemotherapy. All liver biopsies were reviewed by a hepatopathologist. Three patients were identified. All patients were diagnosed with cancer within 7 years of liver transplantation; two-thirds died soon after the diagnosis of malignancy. Rejection occurred soon after chemotherapy was started. All patients were receiving prednisone and tacrolimus (trough levels: 2.1-4.8 ng/mL). One patient developed plasma cell hepatitis (de novo autoimmune hepatitis). There was no histologic evidence of hepatotoxicity due to the chemotherapeutic agents. Cytotoxic chemotherapy should be used in liver transplant recipients with caution, and immunosuppressant doses should be maintained at therapeutic levels, as patients may be at risk for allograft rejection. Treatment of rejection or plasma cell hepatitis in this setting should be undertaken in a timely and aggressive fashion to prevent chronic ductopenic rejection.

Original languageEnglish
Pages (from-to)634-639
Number of pages6
JournalLiver Transplantation
Volume15
Issue number6
DOIs
StatePublished - 2009

Fingerprint

Dive into the research topics of 'Graft rejection occurring in post-liver transplant patients receiving cytotoxic chemotherapy: A case series'. Together they form a unique fingerprint.

Cite this