Liver transplantation after hematopoietic stem cell transplantation in sickle cell disease

Abstract

Objective: This work describes an unprecedented case in the literature of hepatic decompensation due to sickle cell disease in a patient who had already been transplanted from bone marrow, which led to the need for liver transplantation Case report: A 51-year-old patient, transplanted with progenitor stem cells due to sickle cell disease to 38 years old, known to have chronic liver disease due to hemosiderosis with high levels of ferritin and transferrin saturation, starts decompensating his liver after dental procedure with drop in hematocrit in successive exams. After the introduction of appropriate therapy for the prevention of spontaneous bacterial peritonitis, he presents new decompensation with suspicion of acute drug hepatitis, requiring admission to the ICU and liver transplantation. After liver transplantation, the patient evolved with improved levels of transferrin and ferritin saturation, without the need for the use of iron chelators. Final considerations: The transplantation of progenitor cells for the treatment of DF is a curative treatment option available, but it is not able to prevent complications inherent to the comorbidities presented before the procedure, such as the progression of chronic liver disease culminating in liver failure.