Graft‐versus‐host disease, a rare complication after orthotopic liver transplantation

Ofosu, Andrew; Zabolotsky, Andrew; Rufail, Miguel; Spataro, Joseph; Civan, Jesse

doi:10.1002/ccr3.1314

Cited by 3 publications

(4 citation statements)

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“…Increasing immunosuppressive therapy is frequently used in the therapy for GvHD following LT. 2 , 3 , 11 – 13 , 15 , 16 , 18 , 19 , 21 , 22 , 24 , 25 , 28 – 30 , 33 , 35 , 37 , 40 – 45 , 48 , 49 , 51 – 55 , 57 , 58 , 60 , 61 , 64 , 65 , 68 , 69 , 71 , 74 , 75 , 77 , 78 , 80 – 83 , 86 – 88 , 90 , 94 , 95 , 98 – 103 , 106 – 108 , 111 , 112 , 114 , 116 – 119 , 122 – 127 , 130 , 132 , 134 , 142 Undoubtedly, increased immunosuppression frequently leads to toxicity and infection, resulting in septic shock. 19 The treatment of GvHD with corticosteroids 4 , 11 , 13 , 19 , 21 , 33 , 36 , 38 , 39 ,…”

Section: Discussionmentioning

confidence: 99%

Graft-versus-host disease following liver transplantation: A systematic review of literature

Kneifel,

Vogel,

Bormann

et al. 2023

Hepatology Communications

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Background: Graft-versus-host disease following liver transplantation is a serious and usually fatal complication. Data identifying the risk factors and specifying the diagnosis and treatment options of the disease are scarce and contentious. Moreover, recommendations for therapeutic approaches are similarly sparse. Methods: A systematic review of the literature from 1988 to 2020 on graft-versus-host disease following liver transplantation was performed using the PubMed and MEDLINE databases. Medical subject headings, such as graft-versus-host disease and GvHD were used in combination with solid organ transplant, transplantation, or liver transplant. Following duplicate removal, 9298 articles were screened for suitability. A total of 238 full-text articles were analyzed for eligibility, resulting in 130 eligible articles for meta-analysis. Two hundred twenty-five patients developing graft-versus-host disease following liver transplantation reported herein were mainly published in case reports and case series. Results: Graft-versus-host disease occurred with an incidence of 1.2%. 85% developed following deceased donor liver transplant and 15% following living-related donor liver transplantation. The median follow-up period following liver transplantation was 84 days (interquartile range, 45–180). The median time from liver transplantation to graft-versus-host disease onset was 30 days (interquartile range, 21–42). The main clinical features included skin rash (59%), fever (43%), diarrhea (36%), and pancytopenia (30%). The overall mortality rate was 71%. Neither univariate (HR = 0.999; 95% CI, 0.493–2.023; p = 1.0) nor multivariate Cox regression analysis revealed a significant correlation between adaptation of immunosuppression and survival probability (HR = 1.475; 95% CI, 0.659–3.303; p = 0.3). Conclusions: This systematic review suggests that an increase in immunosuppressive regimen does not yield any survival benefit in patients suffering from graft-versus-host disease following liver transplantation.

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Section: Discussionmentioning

confidence: 99%

Graft-versus-host disease following liver transplantation: A systematic review of literature

Kneifel,

Vogel,

Bormann

et al. 2023

Hepatology Communications

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“…Duplicates excluded were the reports by Kuball et al (Schuchmann et al reported their patient ), by Sudhindran et al and Taylor et al (Key et al had described their patients ), and by Neumann et al (Kohler et al had previously published their patient ). A total of 78 studies were withheld, in which a total of 150 patients with LTx‐associated GVHD were identified …”

Section: Methodsmentioning

confidence: 99%

Improved survival after LTx-associated acute GVHD with mAb therapy targeting IL2RAb and soluble TNFAb: Single-center experience and systematic review

Minnee

Fieuws

Jochmans

et al. 2018

American Journal of Transplantation

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Acute graft-versus-host disease (GVHD) after liver transplant (LTx) is a rare complication with a high mortality rate. Recently, monoclonal antibody (mAb) treatment, specifically with anti-interleukin 2 receptor antibodies (IL2RAb) and anti-tumor necrosis factor-α antibodies (TNFAb), has gained increasing interest. However, evidence is mostly limited to case reports and the efficacy remains unclear. Here, we describe 5 patients with LTx-associated GVHD from our center and provide the results of our systematic literature review to evaluate the potential therapeutic benefit of IL2RAb/TNFAb treatment. Of the combined population of 155 patients (5 in our center and 150 through systematic search), 24 were given mAb (15.5%)-4 with TNFAb (2.6%) and 17 with IL2RAb (11%) ("mAb group")-and compared with patients who received other treatments (referred to as "no-mAb group"). Two-sided Fisher exact tests revealed a better survival when comparing treatment with mAb versus no-mAb (11/24 vs 27/131; P = .018), TNFAb versus no-mAb (3/4 vs 27/131; P = .034), and IL2RAb versus no-mAb (8/17 vs 27/131; P = .029). This systematic review suggests a beneficial effect of mAb treatment and a promising role for TNFAb and IL2RAb as a first-line strategy to treat LTx-associated acute GVHD.

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“…-Поражение желудочно-кишечного тракта наиболее часто проявляется диареей (у 54% реципиентов) [4]. Может наблюдаться изъязвление слизистой рта [10], язвенное поражение пищевода [15]. В нашем первом наблюдении имел место выраженный гастрит, дуоденит; описаны также илеит и колит, которые могут привести к развитию кишечной непроходимости [11] или желудочнокишечному кровотечению [14].…”

Section: Abstract: Liver Transplantation Graft-versus-host Diseaseunclassified

“…Диагностика РТПХ основана на гистологическом исследовании пораженной ткани. Чаще всего диагноз ставится на основе материала из ЖКТ [20] или биопсии кожи [13,15]. Для дифференциального диагноза между различными дерматологическими заболеваниями могут быть использованы иммуногистохимические методы [21].…”

Section: Abstract: Liver Transplantation Graft-versus-host Diseaseunclassified

Development of graft-versus-host disease in a liver recipient. Clinical observations and literature review

Voskanyan,

Korobka,

Syutkin

et al. 2023

RJTAO

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Graft-versus-host disease (GvHD) after liver transplantation (LT) occurs in 0.2–0.3% of liver transplant recipients. Each case is characterized by individual peculiarities of the clinical picture. There are no standards or clinical guidelines for the treatment of GvHD in solid organ recipients; mortality remains very high among these patients. We present two clinical cases of verified GvHD that developed early after LT, and we offer a brief review of the current state of the art in the study of this problem.

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Graft‐versus‐host disease, a rare complication after orthotopic liver transplantation

Cited by 3 publications

References 1 publication

Graft-versus-host disease following liver transplantation: A systematic review of literature

Graft-versus-host disease following liver transplantation: A systematic review of literature

Improved survival after LTx-associated acute GVHD with mAb therapy targeting IL2RAb and soluble TNFAb: Single-center experience and systematic review

Development of graft-versus-host disease in a liver recipient. Clinical observations and literature review

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