医学
脑出血
外科
肝移植
重症监护室
磁共振成像
格拉斯哥昏迷指数
血肿
开颅术
放射科
移植
内科学
作者
Hüseyin Yönder,Sami Akbulut,Huseyin Kocaaslan,Volkan İnce,Neşe Karadağ,Gökhan Demirtaş,Ayşe Selimoğlu,Sezai Yilmaz
出处
期刊:Experimental and Clinical Transplantation
[Baskent University Publishers]
日期:2021-01-01
卷期号:19 (1): 83-87
被引量:1
标识
DOI:10.6002/ect.2016.0274
摘要
Early or late posttransplant opportunistic infections are among the leading complications after liver transplant. The source of early posttransplant opportunistic infections is usually the patient, the implantation of an infected graft, contamination during a surgical procedure, or invasive interventions performed at the intensive care unit. A 10-year-old male patient with Wilson disease (Pediatric End-Stage Liver Disease Score of 42, Child-Pugh score of 12, total bilirubin 40 mg/dL, platelet count 55000/mL, hemoglobin level 6.3 g/dL, albumin level 1.7 g/dL, urinary copper level 4305 μ/24 h) was closely monitored in the pediatric intensive care unit of our liver transplantation center for care of a worsened general status. A deceased-donor liver transplant was performed using a right lobe liver graft (ex vivo split) obtained through the national organ sharing network. The patient developed rightward deviation of eyes and altered consciousness after the procedure and underwent cranial magnetic resonance imaging and computerized tomography examinations. The cranial magnetic resonance image, taken on the third postoperative day, revealed lesions consistent with embolic infarction, and the computed tomography scan, taken on the eighth day, showed intracerebral hemorrhage. Decompressive craniotomy, which included hematoma drainage and catheter placement, was performed. Culture and histopathologic examinations of the hematoma material revealed a Penicillium species of fungi. However, the patient died before a definitive diagnosis was made. The aim of this report is to raise awareness on early posttransplant opportunistic infections of the central nervous system presenting with intracranial hemorrhage following liver transplant.
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