Diagnosis and Treatment for Graft-Versus-Host Disease After Liver Transplantation: Two Case Reports

Wang, B.; Lu, Yan-qing; Lei, Yu; Liu, C.; Wu, Zhengcheng; Liu, X.

doi:10.1016/j.transproceed.2007.02.078

Cited by 20 publications

(17 citation statements)

References 10 publications

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“…Thus, there are recent reports of three patients with GVHD after OLT in whom immunosuppression was stopped. Two of them survived, indicating a better outcome with this therapeutic strategy,16,27 by inducing a host-versus-graft alloimmune response against host-reactive donor-derived cells. Moreover, withdrawal of immunosuppression may help the recipient's immune system to reconstitute itself, thereby reducing the risk of infection.…”

Section: Discussionmentioning

confidence: 96%

Graft-versus-host disease after liver transplantation

Chaib

Silva

Figueira

et al. 2011

Clinics

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Section: Discussionmentioning

confidence: 96%

Graft-versus-host disease after liver transplantation

Chaib

Silva

Figueira

et al. 2011

Clinics

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“…Some authors proposed a reduction or even withdrawal of immunosuppression in order to restore the recipient's immune system to fight the immune attack of the donor (7). Some others immunosuppression increase with different patterns: increased basal immunosuppression, adding methyl-prednisolone boluses (2,4), or the use of antilymphocyte therapy such as anti-thymocyte globulin, antilymphocyte globulin, OKT3, daclizumab or basiliximab, guest cell infusion, rapamycin (3,(8)(9)(10)(11)(12)(13).…”

Section: Discussionmentioning

confidence: 99%

Graft versus host disease as a complication after liver transplantation: A rare but serious association

Pérez-Saborido¹,

Asensio-Díaz²,

Barrera-Rebollo³

et al. 2015

Rev Esp Enferm Dig

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“…5 A completely opposite approach for treating GVHD is a withdrawal of immunosuppression, based on the idea that the host immune system may reject the donor lymphocytes that mediate GVHD. 2 Both adults 16 and children have been treated successfully by decreasing immunosuppression, despite the risks of worsened symptoms and graft rejection. Infusion of host immune cells to treat GVHD has been successful in 2 cases.…”

Section: Discussionmentioning

confidence: 99%

Treatment of Liver Transplant Graft-Versus-Host Disease With Antibodies Against Tumor Necrosis Factor-α

Blank

Li²,

Kratt³

et al. 2012

Exp Clin Transplant

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Acute graft-versus-host disease is uncommon after liver transplant. We recently treated a 60-year-old man with liver transplant for hepatocellular carcinoma. After the primary liver transplant graft did not function, revision liver transplant resulted in excellent function. Subsequently, the patient developed watery diarrhea, systemic inflammatory response syndrome, a skin rash on his limbs and trunk, and palmar erythema. Skin biopsy suggested viral exanthems consistent with cytomegalovirus. Despite treatment for cytomegalovirus, intestinal symptoms worsened. Analysis of peripheral blood with fluorescence-activated cell sorting showed a high proportion of T lymphocytes, with 5% to 10% T cells specific to the second donor, suggestive of graft-versus-host disease. Within 48 hours after beginning therapy with antibodies against tumor necrosis factor-α (infliximab), the skin rash disappeared and endoscopy showed slight improvement of the mucosal regeneration. However, despite antifungal prophylaxis with caspofungin, the patient developed angioinvasive pulmonary aspergillosis and multiple organ failure, and he died. In conclusion, typical clinical symptoms of graftversus-host disease after liver transplant may include skin rash and gastrointestinal symptoms, and diagnosis may be confirmed by histologic examination and testing for blood chimerism. A consensus for the treatment of graft-versus-host disease still is lacking, but tumor necrosis factor-α is an encouraging target for therapy to decrease the symptoms of graft-versus-host disease and enable mucosal regeneration.

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Diagnosis and Treatment for Graft-Versus-Host Disease After Liver Transplantation: Two Case Reports

Cited by 20 publications

References 10 publications

Graft-versus-host disease after liver transplantation

Graft-versus-host disease after liver transplantation

Graft versus host disease as a complication after liver transplantation: A rare but serious association

Treatment of Liver Transplant Graft-Versus-Host Disease With Antibodies Against Tumor Necrosis Factor-α

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