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Volume: 6 Issue: 4 November 2008 - Supplement - 1

FULL TEXT

LATE ASPERGILLUS ABCESS IN LIVER GRAFT

Liver transplantation has become gold standard for end stage liver diseases. But Turkey like other countries has struggled to achieve cadaver donation. Thus, this shortage of cadaveric donations lead doctors to use marginal donors. Donor was a 16 years old man. Cause of brain death was Coumadin associated cranial bleeding. Donor had history of heart valve surgery. The harvesting was done 16th days after ICU staying when the blood culture was positive with Aspergillus. Liver and two kidneys were transplanted from this donor. The liver recipient was 29 years old woman. Chronic liver disease was secondary to HBV+delta infection. The transplantation was performed in Gazi University Transplantation Center on December 2007. She had an uneventful postoperative period with Tacrolimus based immunosuppression and discharged on day 10. Then, she admitted to hospital due to biliary stenosis and related elevation of liver enzymes and bilirubin. Results revealed that, she had biliary anastomotic stricture. The biliary dilatation was performed. She discharged without any problem. Seven months after transplantation she admitted to hospital with fever, weight loss, and liver enzymes elevation. Solid lesions were seen at the liver graft in the abdominal USG. Biopsy was performed. Fungus was found in the biopsy. We searched the outcome of the two other kidneys. We learned that patients were undergone graft nephrectomy due to aspergillus abscess in the graft. Because voriconazole did not have any benefit, the ambizone treatment was started. She is doing well in her seventeen months of transplantation.



Volume : 6
Issue : 4
Pages : 200


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Gazi University Transplantation Center, Gazi University Medical Faculty, Ankara, Turkey