Aplastic Anemia Complicating Orthotopic Liver Transplantation for Non-A, Non-B Hepatitis

A. G. Tzakis, M. Arditi, P. F. Whitington*, K. Yanaga, C. Esquivel, W. A. Andrews, L. Makowka, J. Malatak, D. K. Freese, P. G. Stock, N. L. Ascher, F. L. Johnson, C. E. Broelsch, T. E. Starzl

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

124 Scopus citations


Aplastic anemia developed in 9 of 32 patients (28 percent) undergoing orthotopic liver transplantation for acute non-A, non-B hepatitis, at one to seven weeks after the procedure. No patient previously had evidence of hematologic dysfunction or conditions known to be associated with aplastic anemia. No other cases of aplastic anemia were identified among 1463 patients undergoing liver transplantation for all other indications at the four centers participating in the study (chi-square = 415, P<0.001; 95 percent confidence interval for the incidence of aplastic anemia after transplantation for non-A, non-B hepatitis, 13 to 44 percent, vs. 0.00 to 0.13 percent for all other indications). The operative and postoperative treatment of these patients was not otherwise different, indicating that the aplastic anemia was a complication of the hepatitis, not of the transplantation procedure. Four of the nine patients died of complications due to infections. Three of the surviving patients have been followed for less than six months, one for one year, and one for two years. The two patients followed the longest have recovered marrow function to an appreciable degree, and two of the others have evidence of early recovery. We conclude that patients undergoing orthotopic liver transplantation for non-A, non-B hepatitis are at a high risk for the development of aplastic anemia. (N Engl J Med 1988; 319:393–6.)

Original languageEnglish (US)
Pages (from-to)393-396
Number of pages4
JournalNew England Journal of Medicine
Issue number7
StatePublished - Aug 18 1988

ASJC Scopus subject areas

  • Medicine(all)


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