A Review of Hemophagocytic Lymphohistiocytosis in Transplant-Focusing on the Heart.

Hemophagocytic lymphohistiocytosis (HLH) is a complex and often difficult-to-diagnose disease that can be easily missed and is associated with high mortality. Transplantation serves as a predisposing factor, and the challenges in diagnosis and treatment are compounded in transplant patients. Although there are only a few documented cases of HLH in heart transplant (HT) recipients, the increasing prevalence of HT globally suggest that more cases are likely to emerge. In this review, we focus on HLH specifically in the context of HT. We present a unique and complex case report of HLH in a HT patient. Following this, we will review the disease in the general population and explore its impact on transplant patients. We will analyze existing data on HLH in HT recipients, clinical symptoms and signs, diagnosis and discuss various treatment strategies including currently recommended and alternative new approaches.