INoEA 2025 7th International Conference on Esophageal Atresia & 11th International PAAFIS Symposium & Aerodigestive Society Meeting

Introduction:

The increased incidence of Kaposi sarcoma is one of the major complications of immunosuppression following liver transplantation. Human herpesvirus 8 (HHV-8), also known as Kaposi’s sarcoma (KS)–associated herpesvirus, is the etiologic agent responsible for all types of KS. It is increasingly important for clinicians to recognize Kaposi’s sarcoma in a wide variety of clinical contexts.

Case report:

A 12-year-old Tunisian boy underwent a living donor left lateral segment liver transplant in September 2019 for primary biliary atresia. Five months post-transplant, the patient developed gingival swelling, erratic fever, and night sweats. Biopsy of the mucosal lesion and immunohistochemistry (IHC) studies confirmed the diagnosis of Kaposi sarcoma. A CT body scan revealed nonspecific lymph nodes, and an esophago-gastroduodenal endoscopy was normal. The hospital did not have access to HHV-8 PCR, but HIV 1 and 2 DNA tests were negative, and CMV and EBV were undetectable in the child's serum. The diagnosis of purely mucosal Kaposi sarcoma was made. Tacrolimus was gradually reduced, and Sirolimus was introduced, leading to partial regression of the gingival lesions.

Conclusion:

Conversion to Sirolimus appears to be effective in halting the proliferation of purely mucosal Kaposi sarcoma following liver transplantation.