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Nakanuma S, Miyashita T, Hayashi H, et al. Extravasated platelet aggregation in liver zone 3 may correlate with the progression of sinusoidal obstruction syndrome following living donor liver transplantation: A case report. Exp Ther Med. 2015;9(4):1119-1124doi: 10.3892/etm.2015.2245.
Nakanuma, S., Miyashita, T., Hayashi, H., Tajima, H., Takamura, H., Tsukada, T., Okamoto, K., Sakai, S., Makino, I., Kinoshita, J., Nakamura, K., Oyama, K., Inokuchi, M., Nakagawara, H., Ninomiya, I., Kitagawa, H., Fushida, S., Fujimura, T., & Ohta, T. (2015). Extravasated platelet aggregation in liver zone 3 may correlate with the progression of sinusoidal obstruction syndrome following living donor liver transplantation: A case report. Experimental and therapeutic medicine, 9(4), 1119-1124. https://doi.org/10.3892/etm.2015.2245
Nakanuma, Shinichi, et al. "Extravasated platelet aggregation in liver zone 3 may correlate with the progression of sinusoidal obstruction syndrome following living donor liver transplantation: A case report." Experimental and therapeutic medicine vol. 9,4 (2015): 1119-1124. doi: https://doi.org/10.3892/etm.2015.2245
Nakanuma S, Miyashita T, Hayashi H, Tajima H, Takamura H, Tsukada T, Okamoto K, Sakai S, Makino I, Kinoshita J, Nakamura K, Oyama K, Inokuchi M, Nakagawara H, Ninomiya I, Kitagawa H, Fushida S, Fujimura T, Ohta T. Extravasated platelet aggregation in liver zone 3 may correlate with the progression of sinusoidal obstruction syndrome following living donor liver transplantation: A case report. Exp Ther Med. 2015 Apr;9(4):1119-1124. doi: 10.3892/etm.2015.2245. Epub 2015 Feb 02. PMID: 25780397; PMCID: PMC4353807.
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Exp Ther Med. 2015 Apr;9(4):1119-1124. doi: 10.3892/etm.2015.2245. Epub 2015 Feb 02.

Extravasated platelet aggregation in liver zone 3 may correlate with the progression of sinusoidal obstruction syndrome following living donor liver transplantation: A case report.

Experimental and therapeutic medicine

Shinichi Nakanuma, Tomoharu Miyashita, Hironori Hayashi, Hidehiro Tajima, Hiroyuki Takamura, Tomoya Tsukada, Koichi Okamoto, Seisho Sakai, Isamu Makino, Jun Kinoshita, Keishi Nakamura, Katsunobu Oyama, Masafumi Inokuchi, Hisatoshi Nakagawara, Itasu Ninomiya, Hirohisa Kitagawa, Sachio Fushida, Takashi Fujimura, Tetsuo Ohta

Affiliations

  1. Department of Gastroenterologic Surgery, Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8641, Japan.

PMID: 25780397 PMCID: PMC4353807 DOI: 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: aggregation; cluster of differentiation 42b; liver transplantation; platelet; sinusoidal obstruction syndrome; veno-occlusive disease

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