Liver Transplantation for Refractory Congenital Cytomegaloviral Hepatitis.

Autor: Aufhauser DD Jr; From the Department of Surgery, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI., Condit P; Department of Pediatrics, University of Wisconsin- Madison School of Medicine and Public Health, Madison, WI., Schmit KM; Department of Pediatrics, University of Wisconsin- Madison School of Medicine and Public Health, Madison, WI., Conway JH; Department of Pediatrics, University of Wisconsin- Madison School of Medicine and Public Health, Madison, WI., Cook S; Department of Pediatrics, University of Wisconsin- Madison School of Medicine and Public Health, Madison, WI., D'Alessandro AM; From the Department of Surgery, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI., Furuya KN; Department of Pediatrics, University of Wisconsin- Madison School of Medicine and Public Health, Madison, WI.
Jazyk: angličtina
Zdroj: JPGN reports [JPGN Rep] 2022 Dec 02; Vol. 4 (1), pp. e275. Date of Electronic Publication: 2022 Dec 02 (Print Publication: 2023).
DOI: 10.1097/PG9.0000000000000275
Abstrakt: Congenital cytomegalovirus (cCMV) is the most common congenital infection. Here, we report on a case of severe, refractory cCMV hepatitis resulting in end-stage liver disease. A male infant born at 37 weeks gestational age presented with petechiae, splenomegaly, and jaundice associated with a direct hyperbilirubinemia, elevated transaminases, and thrombocytopenia. Urine screen was positive for CMV, and he was treated with valganciclovir. He progressed to decompensated cirrhosis with ascites, hypoglycemia, and coagulopathy and was listed for liver transplant at 4 months of age. At 5 months of age, he developed massive hematemesis with hemorrhagic shock and underwent emergent portocaval shunt followed by living donor liver transplant with a left lateral segment graft. Postoperatively, he received CMV immune globulin and intravenous ganciclovir and cleared his viremia by 2 months post-transplant. This case illustrates the diagnostic and management challenges of severe cCMV hepatitis and reports a successful liver transplantation despite active CMV viremia.
Competing Interests: The authors report no conflicts of interest.
(Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.)
Databáze: MEDLINE
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