Dermatologic manifestations of solid organ transplantation–associated graft-versus-host disease: A systematic review

Abstract

GVHD is a potentially fatal condition that can occur after SOT and often presents with a skin rash. We recommend that dermatologists have a low threshold to consider and pursue this diagnosis in the setting of post-SOT skin eruption.

Clinical and histopathologic manifestations of solid organ transplantation‐associated graft‐versus‐host disease involving the skin: A single‐center retrospective study

“…While the presence of donor lymphocytes in the skin does not in itself confirm GVHD, the location of these donor lymphocytes at the dermal‐epidermal junction and exocytosis within the epidermis close to the satellite cell necrosis were interpreted as being supportive of a diagnosis of GVHD. While PCR‐based chimerism studies were helpful in each case tested in this series, the imperfect sensitivity of this assay may lead to falsely negative test results in some instances . Although FISH and chimerism studies are labor‐intensive and therefore have delayed turn‐around time, our study revealed them to be a specific means of diagnosing GVHD, not only for orthotopic liver transplant patients, but also for recipients of other solid organs, such as bilateral lung transplant.…”

“…While PCR-based chimerism studies were helpful in each case tested in this series, the imperfect sensitivity of this assay may lead to falsely negative test results in some instances. 4 Although FISH and chimerism studies are labor-intensive and therefore have delayed turn-around time, our study revealed them to be a specific means of diagnosing GVHD, not only for orthotopic liver transplant patients, but also for recipients of other solid organs, such as bilateral lung transplant. Given the high mortality rate observed in the present cohort of patients, we were unable to determine effective treatment options for SOT GVHD.…”

“…The immune reaction that unfolds typically affects the skin, gastrointestinal tract, and liver. While GVHD following allogeneic hematopoietic cell transplantation (HCT) is a well‐described phenomenon developing in 9% to 50% of HCT recipients, its occurrence after solid organ transplantation (SOT) is rare and infrequently described in the literature …”

“…While GVHD following allogeneic hematopoietic cell transplantation (HCT) is a welldescribed phenomenon developing in 9% to 50% of HCT recipients, its occurrence after solid organ transplantation (SOT) is rare and infrequently described in the literature. [1][2][3][4] When GVHD does occur following SOT, the majority of patients experience dermatologic manifestations. A recent systematic review of the literature regarding SOT-associated GVHD (SOT GVHD) 4 identified 115 previously reported patients with SOT GVHD, the majority of whom were documented in isolated case reports.…”

“…[1][2][3][4] When GVHD does occur following SOT, the majority of patients experience dermatologic manifestations. A recent systematic review of the literature regarding SOT-associated GVHD (SOT GVHD) 4 identified 115 previously reported patients with SOT GVHD, the majority of whom were documented in isolated case reports. SOT GVHD in the pediatric population has also been characterized in case reports and small case series, as summarized in a recent literature review.…”