PURPOSE: Graft-versus-host disease (GVHD) after organ transplantation is a rare but life-threatening complication with very high mortality. METHODS: A retrospective review was performed of all patients undergoing small bowel or combined organ transplantation at a single institution during 2003 to 2009. Patients with donor T-cell chimerism were analyzed in detail for development of GVHD. RESULTS: Thirty-two patients were included in the study. Of 32 patients, 11 (34%) had donor T-cell chimerism (range, 0%-53%) studies performed; 7 (64%) of those 11 patients demonstrated clinical features of GVHD. All patients who demonstrated GVHD had detectable donor T-cell chimerism. All patients with GVHD presented with skin involvement. Graft-versus-host disease responded to increased immune suppression therapy. Mortality was 43% (3/7) among patients with GVHD and was caused by multiorgan failure and sepsis in all cases. CONCLUSION: Acute and chronic GVHD were observed frequently after combined solid organ transplantation and were associated with significant mortality and morbidity. Alloreactive donor T cells cotransplanted with the organ likely play a role in the pathophysiology because levels of donor-derived T-cell chimerism correlated with the clinical course of GVHD.
PURPOSE:Graft-versus-host disease (GVHD) after organ transplantation is a rare but life-threatening complication with very high mortality. METHODS: A retrospective review was performed of all patients undergoing small bowel or combined organ transplantation at a single institution during 2003 to 2009. Patients with donor T-cell chimerism were analyzed in detail for development of GVHD. RESULTS: Thirty-two patients were included in the study. Of 32 patients, 11 (34%) had donor T-cell chimerism (range, 0%-53%) studies performed; 7 (64%) of those 11 patients demonstrated clinical features of GVHD. All patients who demonstrated GVHD had detectable donor T-cell chimerism. All patients with GVHD presented with skin involvement. Graft-versus-host disease responded to increased immune suppression therapy. Mortality was 43% (3/7) among patients with GVHD and was caused by multiorgan failure and sepsis in all cases. CONCLUSION: Acute and chronic GVHD were observed frequently after combined solid organ transplantation and were associated with significant mortality and morbidity. Alloreactive donor T cells cotransplanted with the organ likely play a role in the pathophysiology because levels of donor-derived T-cell chimerism correlated with the clinical course of GVHD.
Authors: J Zuber; S Rosen; B Shonts; B Sprangers; T M Savage; S Richman; S Yang; S P Lau; S DeWolf; D Farber; G Vlad; E Zorn; W Wong; J Emond; B Levin; M Martinez; T Kato; M Sykes Journal: Am J Transplant Date: 2015-05-18 Impact factor: 8.086
Authors: Martin W von Websky; Koji Kitamura; Isis Ludwig-Portugall; Christian Kurts; Maximilian von Laffert; Joel LeMaoult; Edgardo D Carosella; Kareem Abu-Elmagd; Joerg C Kalff; Nico Schäfer Journal: PLoS One Date: 2016-07-12 Impact factor: 3.240
Authors: Stuart S Kaufman; Elsadig Hussan; Alexander Kroemer; Olga Timofeeva; Helena B Pasieka; Juan Francisco Guerra; Nada A Yazigi; Khalid M Khan; Udeme D Ekong; Sukanya Subramanian; Jason S Hawksworth; Raffaelle Girlanda; Shahira S Ghobrial; Thomas M Fishbein; Cal S Matsumoto Journal: Transplant Direct Date: 2021-07-19