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Rare causes of hyperbilirubinemia after lung transplantation: our experience at a single center

 Su Hwan Lee  ;  Moo Suk Park  ;  Jin Gu Lee  ;  Joo Han Song  ;  Kyung Soo Chung  ;  Ji Ye Jung  ;  Eun Young Kim  ;  Young Sam Kim  ;  Se Kyu Kim  ;  Joon Chang  ;  Hyo Chae Paik  ;  Song Yee Kim 
 JOURNAL OF THORACIC DISEASE, Vol.9(12) : 5030-5039, 2017 
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Lung transplantation ; hemophagocytic lymphohistiocytosis (HLH) ; hyperbilirubinemia ; ischemic cholangiopathy ; thrombotic microangiopathy (TMA)
Background: Lung transplantation is the last treatment option for end-stage lung disease, and the number of lung transplantations has been steadily increasing. Hyperbilirubinemia is a rare complication after lung transplantation. The aim of this study was to review rare causes of hyperbilirubinemia after lung transplantation at our center. Methods: In this single-center study, we retrospectively reviewed the records of 116 consecutive lung transplantation patients who underwent lung transplantation at Severance Hospital and Gangnam Severance Hospital of Yonsei University College of Medicine in South Korea between December 22, 2010 and January 1, 2016. Hyperbilirubinemia was defined as a total bilirubin level exceeding 5 mg/dL for at least 3 days after lung transplantation. Results: Hyperbilirubinemia occurred in 33 patients (28.4%) who received lung transplants at our institution. Twenty-four cases involved common causes such as drug toxicity, biliary tract stone, sepsis, and bleeding. However, rare causes of hyperbilirubinemia including hemophagocytic lymphohistiocytosis (HLH), thrombotic microangiopathy (TMA), and ischemic cholangiopathy were observed in 9 (7.8%) patients during the study period. All patients with hyperbilirubinemia due to a rare cause died despite aggressive treatment. Conclusion: Causes of hyperbilirubinemia after lung transplantation are varied, and the prognosis of patients with hyperbilirubinemia arising from rare causes was poor. Therefore, early evaluation and management of hyperbilirubinemia after lung transplantation is important to improve patient outcomes.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
김세규(Kim, Se Kyu)
김송이(Kim, Song Yee) ORCID logo https://orcid.org/0000-0001-8627-486X
김순일(Kim, Soon Il) ORCID logo https://orcid.org/0000-0002-0783-7538
김영삼(Kim, Young Sam) ORCID logo https://orcid.org/0000-0001-9656-8482
김은영(Kim, Eun Young) ORCID logo https://orcid.org/0000-0002-3281-5744
박무석(Park, Moo Suk) ORCID logo https://orcid.org/0000-0003-0820-7615
백효채(Paik, Hyo Chae) ORCID logo https://orcid.org/0000-0001-9309-8235
송주한(Song, Joo Han)
이수환(Lee, Su Hwan) ORCID logo https://orcid.org/0000-0002-3487-2574
이진구(Lee, Jin Gu)
장준(Chang, Joon) ORCID logo https://orcid.org/0000-0003-4542-6841
정경수(Jung, Kyung Soo) ORCID logo https://orcid.org/0000-0003-1604-8730
정지예(Jung, Ji Ye) ORCID logo https://orcid.org/0000-0003-1589-4142
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