Hemoglobinopathies and Related Disorders
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A 37-year-old man who developed recurrent sickle cell hepatopathy 12 months postliver transplant despite maintaining hemoglobin S levels below 30% per American Society of Hematology recommendations is presented, illustrating that standard posttransplant HbS targets may be insufficient in high-risk patients.
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ABSTRACT Sickle cell hepatopathy is an uncommon but severe cause of liver dysfunction after transplantation. We present a case of a 37-year-old man who developed recurrent sickle cell hepatopathy 12 months postliver transplant despite maintaining hemoglobin S (HbS) levels below 30% per American Society of Hematology recommendations. Liver biopsy demonstrated sinusoidal sickling without rejection. Liver tests improved after intensifying red cell exchange to achieve HbS below 20%. This case illustrates that standard posttransplant HbS targets may be insufficient in high-risk patients and highlights the need for individualized HbS goals.
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@article{Aslam2026Recurrent,
title = {Recurrent Sickle Cell Hepatopathy After Liver Transplantation Despite Guideline-Directed Red Blood Cell Exchange},
author = {Muhammad Nouman Aslam and Maddison Weber and Ahmed Al-Hindawi and Sarah Park and Gautam Maddineni and Anjana Pillai},
journal = {ACG Case Reports Journal},
year = {2026},
doi = {10.14309/crj.0000000000002293},
url = {https://doi.org/10.14309/crj.0000000000002293}
}FAQ
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