Graft-versus-host disease after liver transplantation

Chaib, Eleazar; Silva, Felipe D.; Figueira, E.; Lima, Fábio; Andraus, Wellington; D’Albuquerque, Luiz Augusto Carneiro

doi:10.1590/s1807-59322011000600035

Cited by 30 publications

(34 citation statements)

References 25 publications

(28 reference statements)

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“…Additionally skin biopsy may show vacuolar degeneration of the basal layer of the epithelium, lymphocytic infiltration of epidermis and necrotic eosinophilic keratinocytes. Spongiosis, basal cell hydropic changes, apoptotic keratinocytes, and lymphocytic exocytosis in the epidermis along with subepidermal cleft formation may also be documented [6]. Chronic post transplant GVHD is characterized by fibrosis in skin and subcutaneous tissue resulting in contracture and alopecia.…”

Section: Clinical Sign and Symptomsmentioning

confidence: 99%

“…Although biopsies from colon and small bowel are gold standard and more GVHD specific, bowel biopsy is not recommended as screening or the first-line investigation for the patients on immunosuppressive drugs due to its invasive nature [4, 6, 19] unless the GI symptoms are present. Further the role of subsequent bowel biopsies to assess the treatment response has also not been determined [20].…”

Section: Clinical Sign and Symptomsmentioning

confidence: 99%

“…The incidence after OLT is 0.1 – 2% [2, 4–5] compared to >50% after hematopoietic stem cell transplantation. A study in 2007 reported about 80 cases of GVHD after OLT [4] and few more cases have been reported since then [6–11]. Graft Versus Host Disease after liver transplant occurs due to immunoreactions mediated by donor T lymphocytes and recipient cell surface antigens such a human leukocyte antigen (HLA) and major histocompatibility complex (MHC) [12].…”

Section: Introductionmentioning

confidence: 99%

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Immunological basis for treatment of graft versus host disease after liver transplant

Rai

Dietz

Agrawal

2016

Expert Review of Clinical Immunology

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Summary Graft versus host disease (GVHD) after liver transplant, although a rare disease, has a very high mortality rate. GVHD occurs due to immunoreactions caused by donor T lymphocytes and host cell surface antigens resulting in proliferation and clonal expansion of T lymphocyte. Migration of effector cells, including macrophages, NK cells and cytotoxic T lymphocyte, to the target organs such as skin, intestine and bone marrow results in skin rashes, diarrhea and bone marrow depression. GVHD is diagnosed by clinical symptoms, histopathological findings and by the presence of chimerism. The delayed diagnosis, opportunistic infections and lack of definitive treatment of post orthotopic liver transplant (OLT)-GVHD results in sepsis and multi-organ failure leading to very low survival rates. In this review, we have focused on early diagnosis and critically discuss novel treatment modalities to decrease the incidence of GVHD.

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Section: Clinical Sign and Symptomsmentioning

confidence: 99%

Section: Clinical Sign and Symptomsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Immunological basis for treatment of graft versus host disease after liver transplant

Rai

Dietz

Agrawal

2016

Expert Review of Clinical Immunology

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“…Graft-Versus-Host Disease (GVHD) is a common complication associated with high mortality that results from the immunologic insult of introducing immunologically competent cells into an immunoincompetent host, which allows these grafted cells to mount a destructive immune response against the recipient tissues [1][2][3][4][5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

“…The skin is one of the initial and main organs affected by GVHD in up to 94.2% of patients [1,7,8,10,11,15], and as such, recognizing these dermatologic manifestations represents an important tool for early diagnosis allowing prompt installation of treatment, although an early start to therapy is not always determinant of outcome [16].…”

Section: Introductionmentioning

confidence: 99%

Skin Signs of Graft Versus Host Disease

Sousa¹,

Herskovitz²

2013

J Bone Marrow Res

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Graft-versus-host disease is a common complication of allogenic hematopoietic cell transplantation and less frequently of solid organ transplantation. The skin is one of the initial and main organs affected, and as such, recognizing the dermatologic manifestations allows early diagnosis and treatment.In this article we aim to describe the cutaneous manifestations of graft-versus-host disease so that non-dermatologist is able to recognize the early signs of this complication.

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