Successful liver transplantation for acute sickle cell intrahepatic cholestasis: A case report and review of the literature

• DOI: 10.4254/wjh.v12.i3.108
• Publication Date: 2020-03-23T05:02:22Z
• Authors: Motasem Alkhayyat; Mohannad Abou Saleh; Mohammad Zmaili; Vedha Sanghi; Tavankit Singh; Carol Rouphael; C Roberto Simons-...; Carlos Romero-Mar...; William D Carey; Christina C Linde...
• Keywords: Liver disease; Hepatitis C

Sickle cell hepatopathy (SCH) is an inclusive term referring to any liver dysfunction among patients with sickle disease. Acute intrahepatic cholestasis one of the rarest and most fatal presentations SCH. We present 23rd reported case transplantation (LT) for SCH; a rare acute managed LT from hepatitis C virus (HCV) nucleic acid amplification test positive donor.A 29-year-old male past medical history disease presented vaso-occlusive pain crisis. On examination, he had jaundice soft, non-tender abdomen. Initially was alert fully oriented; within 24 h developed new-onset confusion. Laboratory evaluation notable hyperbilirubinemia, leukocytosis, anemia, thrombocytopenia, kidney injury elevated international normalized ratio (INR). Imaging by ultrasound computed tomography scan suggested cirrhotic morphology no evidence biliary ductal dilatation. The patient diagnosed after excluding competing etiologies injury. He underwent HCV donor 9 d initial presentation. explant widespread sinusoidal dilatation innumerable clusters sickled red blood cells cholestasis. postoperative day 3, RNA detectable in patient's peripheral anti-HCV therapy glecaprevir/pibrentasvir initiated on 23. subsequently achieved sustained virologic response completing 3 mo has been followed clinically 12 post-transplant.This highlights utility as viable treatment option