Liver Transplantation for Nijmegen Breakage Syndrome With Hepatic Malignancy and Hepatopulmonary Syndrome After Bone Marrow Transplantation: A Case Report.

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY
Oğuzhan Şal, Fatih Erbey, Ayşe Armutlu, Gülsün Karasu, Barış Demir, Nuray Uslu Kızılkan, Akın Akbulut, Turan Kanmaz, Altan Alim
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Abstract

Background: Nijmegen breakage syndrome (NBS) is an autosomal recessive DNA repair disorder that manifests through increased genomic instability, malignancy, and cellular and humoral immunodeficiencies. The prognosis for NBS patients is poor due to their increased susceptibility to fatal infections and lymphoproliferative malignancies. Currently, there is no specific treatment for NBS, though allogeneic hematopoietic stem cell transplantation (HSCT) has been performed and documented as case series to demonstrate the utility of transplantation.

Methods: A 14-year-old girl with NBS and haploidentical HSCT from her older brother due to recurrent lung infection was referred for liver transplantation (LT) due to liver cirrhosis, hepatopulmonary syndrome (HPS), and suspicion of liver malignancy. It was decided to perform LT using the living donor who had previously donated for HSCT.

Results: Living donor left lobe LT was successfully performed from her brother. The patient experienced no complications in the early postoperative period and was discharged on the seventh postoperative day. Pathological examination of extracted liver has shown "intermediate cell carcinoma" in two foci. After 1 year LT, the patient has had an uneventful course in terms of LT complications and infection, with minimal immunosuppression.

Conclusions: NBS patients have an increased prevalence of malignancies, including primary hepatic malignancy, but most are managed medically or with limited resections. Transplantation in these patients can be curative for hepatic malignancy with a favorable safety profile.

肝移植治疗奈梅亨断裂综合征伴肝脏恶性肿瘤和骨髓移植后肝肺综合征:病例报告。
背景:奈梅亨断裂综合征(NBS)是一种常染色体隐性遗传 DNA 修复障碍,表现为基因组不稳定性增加、恶性肿瘤以及细胞和体液免疫缺陷。由于 NBS 患者对致命感染和淋巴增生性恶性肿瘤的易感性增加,他们的预后很差。目前,NBS尚无特效治疗方法,但已进行了异基因造血干细胞移植(HSCT),并记录了系列病例,以证明移植的效用:方法:一名14岁女孩因反复肺部感染而患有NBS并与哥哥进行了单倍体造血干细胞移植,因肝硬化、肝肺综合征(HPS)和怀疑肝脏恶性肿瘤而转诊进行肝移植(LT)。结果:结果:患者成功地接受了由其兄弟捐献的活体肝左叶移植。患者在术后早期未出现并发症,并于术后第七天出院。提取的肝脏病理检查显示有两个病灶为 "中间细胞癌"。LT一年后,患者在LT并发症和感染方面进展顺利,免疫抑制极少:结论:NBS 患者的恶性肿瘤(包括原发性肝恶性肿瘤)发病率较高,但大多数患者都能通过药物治疗或有限的切除手术得到控制。对这些患者进行移植可以治愈肝脏恶性肿瘤,而且安全性良好。
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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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