Myelopathy due to human T-cell leukemia virus type-1 from the donor after ABO-incompatible liver transplantation

Taiga Wakabayashi, Hideaki Obara, Morinobu Seki, Masahiro Shinoda, Minoru Kitago, Hiroshi Yagi, Yuta Abe, Kentaro Matsubara, Yohei Yamada, Go Oshima, Koichi Oki, Narihito Nagoshi, Koota Watanabe, Taizo Hibi, Osamu Itano, Ken Hoshino, Norihiro Suzuki, Tatsuo Kuroda, Yuukou Kitagawa

Research output: Contribution to journalArticle

Abstract

We report the case of a 53-year-old-man who developed human T-cell leukemia virus type-1-associated myelopathy (HAM) after ABO-incompatible liver transplantation for alcoholic liver cirrhosis. The living donor was seropositive for human T-cell leukemia virus type-1 (HTLV-1) and the recipient was seronegative for HTLV-1 before transplantation. After transplantation, the recipient developed steroid-resistant acute cellular rejection, which was successfully treated using anti-thymocyte globulin, and he was eventually discharged. He underwent spinal surgery twice after the transplantation for the treatment of cervical spondylosis that had been present for a period of 9 months before the transplantation. The surgery improved his gait impairment temporarily. However, his gait impairment progressed, and magnetic resonance imaging revealed multiple sites of myelopathy. He was diagnosed with HAM 16 months after the transplantation. Pulse steroid therapy (1000mg) was administered over a period of 3 days, and his limb paresis improved. Presently, steroid therapy is being continued, with a plan to eventually taper the dose, and he is being carefully followed up at our institution. Our case suggests that liver transplantation involving an HTLV-1-positive living donor carries the risk of virus transmission and short-term development of HAM after transplantation.

Original languageEnglish
Pages (from-to)397-401
Number of pages5
JournalAnnals of hepatology
Volume18
Issue number2
DOIs
Publication statusPublished - 2019 Mar 1

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Deltaretrovirus
Spinal Cord Diseases
Liver Transplantation
Transplantation
Tissue Donors
Living Donors
Steroids
Gait
Spondylosis
Alcoholic Liver Cirrhosis
Antilymphocyte Serum
Paresis
Therapeutics
Extremities
Magnetic Resonance Imaging
Viruses

Keywords

  • ABO blood-type barrier
  • HTLV-1-associated myelopathy
  • Living-donor liver transplantation
  • Transmission

ASJC Scopus subject areas

  • Hepatology

Cite this

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title = "Myelopathy due to human T-cell leukemia virus type-1 from the donor after ABO-incompatible liver transplantation",
abstract = "We report the case of a 53-year-old-man who developed human T-cell leukemia virus type-1-associated myelopathy (HAM) after ABO-incompatible liver transplantation for alcoholic liver cirrhosis. The living donor was seropositive for human T-cell leukemia virus type-1 (HTLV-1) and the recipient was seronegative for HTLV-1 before transplantation. After transplantation, the recipient developed steroid-resistant acute cellular rejection, which was successfully treated using anti-thymocyte globulin, and he was eventually discharged. He underwent spinal surgery twice after the transplantation for the treatment of cervical spondylosis that had been present for a period of 9 months before the transplantation. The surgery improved his gait impairment temporarily. However, his gait impairment progressed, and magnetic resonance imaging revealed multiple sites of myelopathy. He was diagnosed with HAM 16 months after the transplantation. Pulse steroid therapy (1000mg) was administered over a period of 3 days, and his limb paresis improved. Presently, steroid therapy is being continued, with a plan to eventually taper the dose, and he is being carefully followed up at our institution. Our case suggests that liver transplantation involving an HTLV-1-positive living donor carries the risk of virus transmission and short-term development of HAM after transplantation.",
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author = "Taiga Wakabayashi and Hideaki Obara and Morinobu Seki and Masahiro Shinoda and Minoru Kitago and Hiroshi Yagi and Yuta Abe and Kentaro Matsubara and Yohei Yamada and Go Oshima and Koichi Oki and Narihito Nagoshi and Koota Watanabe and Taizo Hibi and Osamu Itano and Ken Hoshino and Norihiro Suzuki and Tatsuo Kuroda and Yuukou Kitagawa",
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T1 - Myelopathy due to human T-cell leukemia virus type-1 from the donor after ABO-incompatible liver transplantation

AU - Wakabayashi, Taiga

AU - Obara, Hideaki

AU - Seki, Morinobu

AU - Shinoda, Masahiro

AU - Kitago, Minoru

AU - Yagi, Hiroshi

AU - Abe, Yuta

AU - Matsubara, Kentaro

AU - Yamada, Yohei

AU - Oshima, Go

AU - Oki, Koichi

AU - Nagoshi, Narihito

AU - Watanabe, Koota

AU - Hibi, Taizo

AU - Itano, Osamu

AU - Hoshino, Ken

AU - Suzuki, Norihiro

AU - Kuroda, Tatsuo

AU - Kitagawa, Yuukou

PY - 2019/3/1

Y1 - 2019/3/1

N2 - We report the case of a 53-year-old-man who developed human T-cell leukemia virus type-1-associated myelopathy (HAM) after ABO-incompatible liver transplantation for alcoholic liver cirrhosis. The living donor was seropositive for human T-cell leukemia virus type-1 (HTLV-1) and the recipient was seronegative for HTLV-1 before transplantation. After transplantation, the recipient developed steroid-resistant acute cellular rejection, which was successfully treated using anti-thymocyte globulin, and he was eventually discharged. He underwent spinal surgery twice after the transplantation for the treatment of cervical spondylosis that had been present for a period of 9 months before the transplantation. The surgery improved his gait impairment temporarily. However, his gait impairment progressed, and magnetic resonance imaging revealed multiple sites of myelopathy. He was diagnosed with HAM 16 months after the transplantation. Pulse steroid therapy (1000mg) was administered over a period of 3 days, and his limb paresis improved. Presently, steroid therapy is being continued, with a plan to eventually taper the dose, and he is being carefully followed up at our institution. Our case suggests that liver transplantation involving an HTLV-1-positive living donor carries the risk of virus transmission and short-term development of HAM after transplantation.

AB - We report the case of a 53-year-old-man who developed human T-cell leukemia virus type-1-associated myelopathy (HAM) after ABO-incompatible liver transplantation for alcoholic liver cirrhosis. The living donor was seropositive for human T-cell leukemia virus type-1 (HTLV-1) and the recipient was seronegative for HTLV-1 before transplantation. After transplantation, the recipient developed steroid-resistant acute cellular rejection, which was successfully treated using anti-thymocyte globulin, and he was eventually discharged. He underwent spinal surgery twice after the transplantation for the treatment of cervical spondylosis that had been present for a period of 9 months before the transplantation. The surgery improved his gait impairment temporarily. However, his gait impairment progressed, and magnetic resonance imaging revealed multiple sites of myelopathy. He was diagnosed with HAM 16 months after the transplantation. Pulse steroid therapy (1000mg) was administered over a period of 3 days, and his limb paresis improved. Presently, steroid therapy is being continued, with a plan to eventually taper the dose, and he is being carefully followed up at our institution. Our case suggests that liver transplantation involving an HTLV-1-positive living donor carries the risk of virus transmission and short-term development of HAM after transplantation.

KW - ABO blood-type barrier

KW - HTLV-1-associated myelopathy

KW - Living-donor liver transplantation

KW - Transmission

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