Mallik Tanuja
DNB Anesthesia Consultant gastroenterology and liver transplant anesthesia, Fortis Escorts Hospital, New Delhi, India
Title: Sickle cell anemia and liver transplant – review of literature
Biography
Biography: Mallik Tanuja
Abstract
Statement of the Problem: Sickle cell disease can lead to hepatic complication ranging from acute hepatic crisis to chronic liver disease including intrahepatic cholestasis and iron overload. There are few case reports of orthotopic liver transplant in patient with sickle cell disease. Its quite challenging but feasible. Methodology & Theoretical Orientation: Data regarding liver transplant in sickle cell hepatopathy is limited. Although it has been proposed on a case by case basis, only a few case series with a total of 18 cases where orthotopic liver transplant was performed has been reported. Findings: A common observation among all these liver transplant patients was that efforts to maintain HbS < 25%30% by red cell exchange and hemoglobin level 810 g/dL were associated with improved posttransplant survival. Even posttransplant liver grafts are at increased risk of vascular thrombosis and graft failure as well as risk of infection due to multiple transfusion. Outcome in these patients can be improved, if the neurological complication can be minimized.