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Case Report: Liver as a Source of Hematopoietic Stem Cells After Liver Transplantation Following Hematopoietic Stem Cell Transplantation

We report a child with Fanconi anemia who, after hematopoietic stem cell transplantation (HSCT) complicated by acute graft-versus-host disease (GVHD), underwent orthotopic liver transplantation (OLT). Approximately 1 month after OLT, the presence of third-party genetic material from the liver donor...

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Autores principales: Jarmoliński, Tomasz, Rosa, Monika, Rybka, Blanka, Ryczan-Krawczyk, Renata, Gajek, Kornelia, Bogunia-Kubik, Katarzyna, Klaudel-Dreszler, Maja, Czubkowski, Piotr, Kaliciński, Piotr, Teisseyre, Joanna, Stefanowicz, Marek, Gorczyńska, Ewa, Kałwak, Krzysztof, Ussowicz, Marek
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8984257/
https://www.ncbi.nlm.nih.gov/pubmed/35402365
http://dx.doi.org/10.3389/fped.2022.861692
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author Jarmoliński, Tomasz
Rosa, Monika
Rybka, Blanka
Ryczan-Krawczyk, Renata
Gajek, Kornelia
Bogunia-Kubik, Katarzyna
Klaudel-Dreszler, Maja
Czubkowski, Piotr
Kaliciński, Piotr
Teisseyre, Joanna
Stefanowicz, Marek
Gorczyńska, Ewa
Kałwak, Krzysztof
Ussowicz, Marek
author_facet Jarmoliński, Tomasz
Rosa, Monika
Rybka, Blanka
Ryczan-Krawczyk, Renata
Gajek, Kornelia
Bogunia-Kubik, Katarzyna
Klaudel-Dreszler, Maja
Czubkowski, Piotr
Kaliciński, Piotr
Teisseyre, Joanna
Stefanowicz, Marek
Gorczyńska, Ewa
Kałwak, Krzysztof
Ussowicz, Marek
author_sort Jarmoliński, Tomasz
collection PubMed
description We report a child with Fanconi anemia who, after hematopoietic stem cell transplantation (HSCT) complicated by acute graft-versus-host disease (GVHD), underwent orthotopic liver transplantation (OLT). Approximately 1 month after OLT, the presence of third-party genetic material from the liver donor was noted and in the next few weeks, the chimerism assessment revealed 100% liver donor leukocytes in the peripheral blood. The rapidly progressing GVHD with gut involvement resulted in patient’s death 6 months after OLT. The liver can act as a clinically significant source of hematopoietic stem cells, and the liver donor’s young age must be emphasized as potentially predisposing to this phenomenon. Transfer of OLT hematopoietic stem cells may not have clinical significance unless the patient is not immunocompetent or develops liver-transplantation associated GVHD, that can result in lymphocyte mediated elimination of original hematopoiesis. Patients with preexisting immunity disorder (such as primary or secondary immunodeficiency) might require intensified immunosuppressive therapy in peritransplant period as a prevention of liver-transplantation associated GVHD. Close monitoring of hematopoietic chimerism after OLT is warranted in patients at risk, because cytopenia or OLT hematopoiesis can reflect subclinical GVHD and further studies are necessary to elucidate this phenomenon.
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spelling pubmed-89842572022-04-07 Case Report: Liver as a Source of Hematopoietic Stem Cells After Liver Transplantation Following Hematopoietic Stem Cell Transplantation Jarmoliński, Tomasz Rosa, Monika Rybka, Blanka Ryczan-Krawczyk, Renata Gajek, Kornelia Bogunia-Kubik, Katarzyna Klaudel-Dreszler, Maja Czubkowski, Piotr Kaliciński, Piotr Teisseyre, Joanna Stefanowicz, Marek Gorczyńska, Ewa Kałwak, Krzysztof Ussowicz, Marek Front Pediatr Pediatrics We report a child with Fanconi anemia who, after hematopoietic stem cell transplantation (HSCT) complicated by acute graft-versus-host disease (GVHD), underwent orthotopic liver transplantation (OLT). Approximately 1 month after OLT, the presence of third-party genetic material from the liver donor was noted and in the next few weeks, the chimerism assessment revealed 100% liver donor leukocytes in the peripheral blood. The rapidly progressing GVHD with gut involvement resulted in patient’s death 6 months after OLT. The liver can act as a clinically significant source of hematopoietic stem cells, and the liver donor’s young age must be emphasized as potentially predisposing to this phenomenon. Transfer of OLT hematopoietic stem cells may not have clinical significance unless the patient is not immunocompetent or develops liver-transplantation associated GVHD, that can result in lymphocyte mediated elimination of original hematopoiesis. Patients with preexisting immunity disorder (such as primary or secondary immunodeficiency) might require intensified immunosuppressive therapy in peritransplant period as a prevention of liver-transplantation associated GVHD. Close monitoring of hematopoietic chimerism after OLT is warranted in patients at risk, because cytopenia or OLT hematopoiesis can reflect subclinical GVHD and further studies are necessary to elucidate this phenomenon. Frontiers Media S.A. 2022-03-23 /pmc/articles/PMC8984257/ /pubmed/35402365 http://dx.doi.org/10.3389/fped.2022.861692 Text en Copyright © 2022 Jarmoliński, Rosa, Rybka, Ryczan-Krawczyk, Gajek, Bogunia-Kubik, Klaudel-Dreszler, Czubkowski, Kaliciński, Teisseyre, Stefanowicz, Gorczyńska, Kałwak and Ussowicz. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pediatrics
Jarmoliński, Tomasz
Rosa, Monika
Rybka, Blanka
Ryczan-Krawczyk, Renata
Gajek, Kornelia
Bogunia-Kubik, Katarzyna
Klaudel-Dreszler, Maja
Czubkowski, Piotr
Kaliciński, Piotr
Teisseyre, Joanna
Stefanowicz, Marek
Gorczyńska, Ewa
Kałwak, Krzysztof
Ussowicz, Marek
Case Report: Liver as a Source of Hematopoietic Stem Cells After Liver Transplantation Following Hematopoietic Stem Cell Transplantation
title Case Report: Liver as a Source of Hematopoietic Stem Cells After Liver Transplantation Following Hematopoietic Stem Cell Transplantation
title_full Case Report: Liver as a Source of Hematopoietic Stem Cells After Liver Transplantation Following Hematopoietic Stem Cell Transplantation
title_fullStr Case Report: Liver as a Source of Hematopoietic Stem Cells After Liver Transplantation Following Hematopoietic Stem Cell Transplantation
title_full_unstemmed Case Report: Liver as a Source of Hematopoietic Stem Cells After Liver Transplantation Following Hematopoietic Stem Cell Transplantation
title_short Case Report: Liver as a Source of Hematopoietic Stem Cells After Liver Transplantation Following Hematopoietic Stem Cell Transplantation
title_sort case report: liver as a source of hematopoietic stem cells after liver transplantation following hematopoietic stem cell transplantation
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8984257/
https://www.ncbi.nlm.nih.gov/pubmed/35402365
http://dx.doi.org/10.3389/fped.2022.861692
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