A case of hepatitis‐associated aplastic anaemia following living‐donor liver transplantation for fulminant hepatitis showing loss of heterozygosity in the 6p chromosome in the affected liver

Author:

Katagiri Takamasa1ORCID,Iwasaki Hiroka1,Fujieda Atsushi23,Kasashima Satomi1,Ozaki Satoru1,Uemori Mizuho1,Ogawa Seishi456,Nakao Shinji7ORCID

Affiliation:

1. Department of Clinical Laboratory Science, Graduate School of Medical Science, Institute of Medical Pharmaceutical and Health Sciences Kanazawa University Kanazawa Ishikawa Japan

2. Department of Hematology and Oncology Mie University Graduate School of Medicine Tsu Mie Japan

3. Department of Hematology Japanese Red Cross Ise Hospital Ise Mie Japan

4. Department of Pathology and Tumor Biology Kyoto University Kyoto Japan

5. Institute for the Advanced Study of Human Biology (WPI‐ASHBi) Kyoto University Kyoto Japan

6. Department of Medicine, Centre for Hematology and Regenerative Medicine Karolinska Institute Stockholm Sweden

7. Department of Hematology, Faculty of Medicine, Institute of Medical Pharmaceutical and Health Sciences Kanazawa University Kanazawa Ishikawa Japan

Abstract

SummaryThe mechanisms underlying hepatitis‐associated aplastic anaemia (HAAA) that occurs several weeks after the development of acute hepatitis are unknown. A 20‐year‐old male developed HAAA following living‐donor liver transplantation for fulminant hepatitis. The patient's leucocytes lacked HLA‐class I due to loss of heterozygosity in the short arm of chromosome 6p (6pLOH). Interestingly, the patient's liver cells resected during the transplantation also exhibited 6pLOH that affected the same HLA haplotype as the leucocytes, suggesting that CD8+ T cells recognizing antigens presented by specific HLA molecules on liver cells may have attacked the haematopoietic stem cells of the patient, leading to the HAAA development.

Funder

Japan Society for the Promotion of Science

Takeda Science Foundation

Publisher

Wiley

Subject

Hematology

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