Korean J Transplant.  2022 Nov;36(Supple 1):S282. 10.4285/ATW2022.F-4245.

Erythrocytosis after liver transplantation: a case report

• Thwin CM
• Mar TT
• Nyunt Oo SA
• Swe NN

• KMID: 2535509
• DOI: http://doi.org/10.4285/ATW2022.F-4245

Abstract

Erythrocytosis is not uncommon after renal transplantation and many studies have been reported. The prevalence and causes of erythrocytosis after liver transplantation have not been studied wide yet. Erythrocytosis after liver transplantation can be defined as an increase in the red cell mass >125% in patients without pre-liver transplant history of this condition. We would like to report a case of erythrocytosis after liver transplantation without definite cause. The patient is 50 years old male with both hepatitis B virus (HBV) and hepatitis C virus (HCV)-associated decompensated cirrhosis of liver with portal hypertension. He underwent liv-er donor liver transplantation in February 2017. Donor was his 25-year-old nephew and right lobe modified graft was used. Hepatic artery thrombosis was observed in postoperative day 1 and revision of hepatic artery was done on this day. HCV was already treated before liver transplant and hepatitis B immune globulin (HBIG) was injected after transplantation. Posttransplant period was uneventful but after 3 years, gradual rise in hematocrit level was noticed. After consultation with hematologist, venesection was started when hematocrit was 57%. He had to do venesection monthly, and now it is up to 18 times. No thromboembolic at-tack has occurred during regular follow-up except dizziness and tingling of extremities. Antiplatelet therapy was continued since transplantation. JAK2 mutation was negative, and no identifiable cause was detected up to now. We reviewed the literatures and possible risk factors are present in this patient including male sex, HBV infection, and HBIG therapy, but no definitive cause and mechanism has not been studied. Further high-volume studies are needed to figure out the cause and treatment of erythrocytosis after liver transplantation.