OBJECTIVE: To document the clinical experience in the diagnosis and treatment of graft-versus-host disease(GVHD) after liver transplantation. METHODS: Clinical course was followed up and laboratory examinations were done in 3 patients with orthotopic liver transplantation (OLT) who developed acute GVHE. The diagnosis depended on clinical manifestations, skin biopsy, HLA typing and PCR short tandem repeat (PCR-STR). Immunosuppressive drugs were transferred and adjusted. RESULTS: Fever, shin rash, diarrhea and pancytopenia were found within 3 to 8 weeks after liver transplantation. The liver function was normal. CMV antigen (pp65) and EBV antibody (IgM) were negative. The donor's HLA was detected in the host's peripheral blood cells. One female recipient had the donor's Y chromosome microchimerism detected by PCR-STR. All 3 patients died from infection, alimentary tract bleeding, or multiple organ failure in the end. CONCLUSION: GVHD is not a rare complication easily misdiagnosed with pessimism out come after liver transplantation.
OBJECTIVE: To document the clinical experience in the diagnosis and treatment of graft-versus-host disease(GVHD) after liver transplantation. METHODS: Clinical course was followed up and laboratory examinations were done in 3 patients with orthotopic liver transplantation (OLT) who developed acute GVHE. The diagnosis depended on clinical manifestations, skin biopsy, HLA typing and PCR short tandem repeat (PCR-STR). Immunosuppressive drugs were transferred and adjusted. RESULTS: Fever, shin rash, diarrhea and pancytopenia were found within 3 to 8 weeks after liver transplantation. The liver function was normal. CMV antigen (pp65) and EBV antibody (IgM) were negative. The donor's HLA was detected in the host's peripheral blood cells. One female recipient had the donor's Y chromosome microchimerism detected by PCR-STR. All 3 patients died from infection, alimentary tract bleeding, or multiple organ failure in the end. CONCLUSION:GVHD is not a rare complication easily misdiagnosed with pessimism out come after liver transplantation.
Authors: Grace Y Kim; Leah A Schmelkin; Mark D P Davis; Rokea A El-Azhary; Ann M Farrell; Alexander Meves; Julia S Lehman Journal: J Am Acad Dermatol Date: 2017-12-27 Impact factor: 11.527