Graft-verse-host disease after liver transplantation: A report of two cases and review of literature

Zhi Yong Guo, Xiao Shun He, Lin Wei Wu, Xiao Feng Zhu, Wei Qiang Ju, Dong Ping Wang, Shen You, Yi Ma, Guo Dong Wang, Jie Fu Huang

Research output: Contribution to journalArticle

13 Scopus citations

Abstract

Graft-verse-host disease (GVHD) is an uncommon fatal complication following liver transplantation (LTx). In mainland China, only six cases have been reported with a morbidity rate up to 1%-2%. Definitive diagnosis was achieved by molecular techniques (HLA typing or PCR-STR) in only two cases and the remaining cases were diagnosed based on typical clinical features with exclusion of other possible causes. All patients died of septic shock or multiple organ failure even after administration of increased corticosteroids and supportive therapy, and reduced immunosuppressive agents. In our center, two cases of GVHD were found among 128 (1.56%) patients. One case was diagnosed by detecting lymphocyte macrochimerism through DNA-STR. Both of them died even after aggressive treatment. In China, the incidence of GVHD is similar to that reported by foreign centers except for an extremely bad prognosis. Rapid diagnosis is crucial for a better prognosis. In China, only 37.5% of cases are diagnosed by molecular methods. We recommend detecting lymphocyte macrochimerism through DNA-STR to get a rapid diagnosis, and interleukin 2-receptor antibody (basiliximab or daclizumab) therapy seems to be a good choice for the disease.

Original languageEnglish (US)
Pages (from-to)974-979
Number of pages6
JournalWorld Journal of Gastroenterology
Volume14
Issue number6
DOIs
StatePublished - Feb 14 2008

Keywords

  • Diagnosis
  • Graft-versus-host disease
  • Liver transplantation
  • Prognosis
  • Treatment

ASJC Scopus subject areas

  • Gastroenterology

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