Extravasated platelet aggregation in liver zone 3 may correlate with the progression of sinusoidal obstruction syndrome following living donor liver transplantation: A case report
Open Access
- 2 February 2015
- journal article
- Published by Spandidos Publications in Experimental and Therapeutic Medicine
- Vol. 9 (4), 1119-1124
- https://doi.org/10.3892/etm.2015.2245
Abstract
Sinusoidal obstruction syndrome (SOS), previously known as veno‑occlusive disease, is relatively rare subsequent to liver transplantation (LT). SOS refractory to medical therapy, however, can result in centrilobular fibrosis, portal hypertension and liver failure. Although sinusoidal endothelial cell damage around central venules (zone 3) occurs early in the development of SOS, the detailed mechanism of SOS development and its association with thrombocytopenia are not yet completely understood. The present report describes a patient who experienced SOS with unexplained thrombocytopenia following living donor LT. The progression of SOS resulted in graft dysfunction and the patient succumbed. The presence of platelets in the liver allograft was assayed immunohistochemically using antibody to the platelet marker cluster of differentiation 42b (platelet glycoprotein Ib). Platelet aggregates were found attached to hepatocytes along the sinusoid and within the cytoplasm of hepatocytes, particularly in zone 3. By contrast, no staining was observed in zone 1. These findings suggested that extravasated platelet aggregation in the space of Disse and the phagocytosis of platelets by hepatocytes were initiated by sinusoidal endothelial cell damage due to the toxicity of the immunosuppressant tacrolimus or a corticosteroid pulse, and that platelet activation and degranulation may be at least partially involved in the mechanism responsible for SOS.Keywords
This publication has 33 references indexed in Scilit:
- Veno-Occlusive Disease/Sinusoidal Obstruction Syndrome Associated With Potential Antibody-Mediated Rejection After Pediatric Living Donor Liver Transplantation: A Case ReportTransplantation Proceedings, 2012
- Transjugular intrahepatic portosystemic shunt for the treatment of sinusoidal obstruction syndrome in a liver transplant recipient and review of the literatureLiver Transplantation, 2011
- Three-dimensional structured illumination microscopy of liver sinusoidal endothelial cell fenestrationsJournal of Structural Biology, 2010
- Role of sialic acid for platelet life span: exposure of β-galactose results in the rapid clearance of platelets from the circulation by asialoglycoprotein receptor–expressing liver macrophages and hepatocytesBlood, 2009
- The Asialoglycoprotein Receptor Regulates Levels of Plasma Glycoproteins Terminating with Sialic Acid α2,6-GalactoseJournal of Biological Chemistry, 2009
- Liver transplantation for sinusoidal obstructive syndrome (veno‐occlusive disease): case report with review of the literature and the UNOS databaseClinical Transplantation, 2008
- Effects of platelet-activating factor and thromboxane A2 on isolated perfused guinea pig liverProstaglandins & Other Lipid Mediators, 2004
- Autologous platelets as a source of proteins for healing and tissue regenerationThrombosis and Haemostasis, 2004
- MELD and PELD: Application of survival models to liver allocationLiver Transplantation, 2001
- Alterations in Endothelial Fenestrations in Liver Sinusoids of Baboons Fed Alcohol: A Scanning Electron Microscopic StudyHepatology, 1984