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Aplastic Anemia Complicating Orthotopic Liver Transplantation for Non-A, Non-B Hepatitis

Tzakis, AG and Arditi, M and Whitington, PF and Yanaga, K and Esquivel, C and Andrews, WA and Makowka, L and Malatak, J and Freese, DK and Stock, PG and Ascher, NL and Johnson, FL and Broelsch, CE and Starzl, TE (1988) Aplastic Anemia Complicating Orthotopic Liver Transplantation for Non-A, Non-B Hepatitis. New England Journal of Medicine, 319 (7). 393 - 396. ISSN 0028-4793

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Aplastic anemia developed in 9 of 32 patients (28 percent) undergoing orthotopic liver transplantation for acute non-A, non-B hepatitis, at one to seven weeks after the procedure. No patient previously had evidence of hematologic dysfunction or conditions known to be associated with aplastic anemia. No other cases of aplastic anemia were identified among 1463 patients undergoing liver transplantation for all other indications at the four centers participating in the study (chi-square = 415, P<0.001; 95 percent confidence interval for the incidence of aplastic anemia after transplantation for non-A, non-B hepatitis, 13 to 44 percent, vs. 0.00 to 0.13 percent for all other indications). The operative and postoperative treatment of these patients was not otherwise different, indicating that the aplastic anemia was a complication of the hepatitis, not of the transplantation procedure. Four of the nine patients died of complications due to infections. Three of the surviving patients have been followed for less than six months, one for one year, and one for two years. The two patients followed the longest have recovered marrow function to an appreciable degree, and two of the others have evidence of early recovery. We conclude that patients undergoing orthotopic liver transplantation for non-A, non-B hepatitis are at a high risk for the development of aplastic anemia. (N Engl J Med 1988; 319:393–6.) © 1988, Massachusetts Medical Society. All rights reserved.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Tzakis, AG
Arditi, M
Whitington, PF
Yanaga, K
Esquivel, C
Andrews, WA
Makowka, L
Malatak, J
Freese, DK
Stock, PG
Ascher, NL
Johnson, FL
Broelsch, CE
Starzl, TEtes11@pitt.eduTES11
Centers: Other Centers, Institutes, Offices, or Units > Thomas E. Starzl Transplantation Institute
Date: 18 August 1988
Date Type: Publication
Journal or Publication Title: New England Journal of Medicine
Volume: 319
Number: 7
Page Range: 393 - 396
DOI or Unique Handle: 10.1056/nejm198808183190702
Institution: University of Pittsburgh
Refereed: Yes
ISSN: 0028-4793
Other ID: uls-drl:31735062130079, Starzl CV No. 856
Date Deposited: 08 Apr 2010 17:14
Last Modified: 02 Feb 2019 13:55


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