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首页> 外文期刊>Transplant international : >Double bone marrow transplantation for severe aplastic anemia after orthotopic liver transplantation: implications for clinical management and immune tolerance.
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Double bone marrow transplantation for severe aplastic anemia after orthotopic liver transplantation: implications for clinical management and immune tolerance.

机译：原位肝移植后双骨髓移植治疗严重再生障碍性贫血：对临床管理和免疫耐受的影响。

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摘要

A 2-year-old boy underwent liver transplantation for fulminant hepatic failure of unknown cause. Four months later the child developed severe aplastic anemia. Allogeneic bone marrow transplantation (BMT) was performed using marrow from his 14-month-old HLA-identical sister. Severe aplastic anemia recurred 2.5 months later. After reconditioning a second BMT was performed using the same donor. Tapering of immunosuppression 2 years after BMT led to biopsy-confirmed rejection of the liver. Therapy with high-dose corticosteroids and an increase in cyclosporine A medication readily reversed rejection and a low-dose immunosuppression reflected by cyclosporine trough levels less than 50 ng/ml has been maintained since. Eight years later the boy is in excellent health with both bone marrow and liver functioning perfectly. In summary, this case demonstrates that even recurrent severe aplastic anemia after OLT can be cured by BMT, and that a transplanted liver can tolerate a double conditioning regimen without problems. Tolerance towards the liver through BMT did not develop.
机译：一名2岁男孩因原因不明的暴发性肝衰竭接受了肝移植。四个月后，孩子发展为严重的再生障碍性贫血。使用他14个月大的HLA相同姐妹的骨髓进行了异体骨髓移植（BMT）。 2.5个月后再次出现严重的再生障碍性贫血。修复后，使用相同的供体进行第二次BMT。 BMT结束两年后免疫抑制作用逐渐减弱，导致活检证实肝脏排斥。从那以后，大剂量的皮质类固醇激素疗法和环孢素的增加使药物易于逆转排斥反应，环孢素谷水平低于50 ng / ml反映出低剂量的免疫抑制作用。八年后，男孩的健康状况良好，骨髓和肝脏均功能正常。总而言之，该病例表明，即使是OLT术后复发的严重再生障碍性贫血，也可以通过BMT治愈，并且移植的肝脏可以耐受双重调节方案而不会出现问题。通过BMT对肝脏的耐受性没有发展。

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