Graft-versus-host disease following living donor liver transplantation

Soejima, Yuji; Shimada, Mitsuo; Suehiro, Taketoshi; Hiroshige, Shoji; Gondo, Hisashi; Takami, Akiyoshi; Yasue, Shizuka; Maehara, Yoshihiko

doi:10.1002/lt.20101

Cited by 50 publications

(50 citation statements)

References 17 publications

(14 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is associated with high mortality due to complications of bleeding, sepsis and multiple organ failure. Close HLA matching has been reported as a risk factor for GVHD in LT. Soejima et al [70] described six cases of GVHD after LT where the donor was homozygous at HLA A,B and DR loci with one haplotype match with the recipient leading HLA mismatch of 1000. This association of donor-dominant one-way HLA matching in the 3 loci of HLA-A, -B, and -DR with GVHD has also been confirmed from other studies [71] .…”

Section: Hla Matching and Graft Versus Host Diseasementioning

confidence: 99%

Matching donor to recipient in liver transplantation: Relevance in clinical practice

Reddy¹,

Varghese²,

Venkataraman³

et al. 2013

WJH

View full text Add to dashboard Cite

Achieving optimum outcomes after liver transplantation requires an understanding of the interaction between donor, graft and recipient factors. Within the cohort of patients waiting for a transplant, better matching of the donor organ to the recipient will improve transplant outcomes and benefit the overall waiting list by minimizing graft failure and need for re-transplantation. A PubMed search was conducted to identify published literature investigating the effects of donor factors such as age, gender, ethnicity, viral serology; graft factors such as size and quality, recipient factors such as age, size, gender and transplant factors such as major or minor blood group incompatibility and immunological factors. We also report technical and therapeutic modifications that can be used to manage donor-recipient mismatch identified from literature and the authors' clinical experience. Multiple donor and recipient factors impact graft survival after liver transplantation. Appropriate matching based on donor-organ-recipient variables, modification of surgical technique and innovative peri-transplant strategies can increase the donor pool by utilizing grafts from marginal donors that are traditionally turned down.

show abstract

Section: Hla Matching and Graft Versus Host Diseasementioning

confidence: 99%

Matching donor to recipient in liver transplantation: Relevance in clinical practice

Reddy¹,

Varghese²,

Venkataraman³

et al. 2013

WJH

View full text Add to dashboard Cite

show abstract

“…Donor-dominant one-way MHC matching (one-way matching between a MHC-homozygous donor and a haploidentical recipient) is a recognized risk factor for aGVHD following liver transplantation [30, 31]. This unidirectional transplant model allows for studies of the graft-versus-host reaction without the obscuring effects of a host-versus-graft reaction that leads to the rejection of donor lymphoid tissues which often occurs in a fully allogeneic transplant model [32].…”

Section: Discussionmentioning

confidence: 99%

Correlation of Chimerism with Acute Graft-versus-Host Disease in Rats following Liver Transplantation

Chen

Bai

et al. 2011

International Journal of Hepatology

View full text Add to dashboard Cite

The accurate diagnosis of acute graft-versus-host disease following liver transplantation (LTx-aGVHD) has been hampered. Chimerism appears in the majority of recipients after LT and its significance in the diagnosis of LTx-aGVHD has not been clearly established. To demonstrate the significance of chimerism on the diagnosis of LTx-aGVHD, we compared the change of chimerism in syngeneic LT recipients, semiallogeneic LT recipients, and LTx-aGVHD induced recipients. Chimerism in PBMCs following sex-mismatched LT was identified by real-time PCR based on a rat Y-chromosome-specific primer. All recipients in semiallogeneic group grew in a normal pattern. However, when 4 × 108 donor splenocytes were transferred simultaneously during LT, the morbidity of lethal aGVHD was 100%. The chimerism appeared slightly higher in the semiallogeneic group than in the syngeneic LT group, but the difference was not significant. However, when the recipients developed lethal aGVHD after LT, chimerism in the PBMCs increased progressively, and even at an early time, a significant increase in chimerism was observed. In conclusion, high level chimerism correlated well with LTx-aGVHD, and detection of chimerism soon after transplantation may be of value in the diagnosis of LTx-aGVHD prior to the onset of symptoms.

show abstract

“…It is reported to be 1.6% among the Caucasian population, and 3.2% among blood donors in Japan. 6 Most GVHD cases in living-related liver transplant have been reported from Japan, [5][6][7][8] where living-related transplant predominate over cadaveric transplant due to ethical and/or cultural concerns regarding the use of cadaveric transplant.…”

Section: Discussionmentioning

confidence: 99%

FISH Diagnosis of Acute Graft-Versus-Host Disease Following Living-Related Liver Transplant

Kanehira

Riegert–Johnson

Dong

et al. 2009

The Journal of Molecular Diagnostics

View full text Add to dashboard Cite

Acute graft-versus-host disease (GVHD) is an uncommon but often fatal complication following liver transplant. We describe a GVHD case in which a female patient with primary biliary cirrhosis underwent a living-related liver transplant from her son. The human leukocyte antigen typing of the donor was homozygous at all loci. The recipient's human leukocyte antigen type was haplo-identical to that of the donor. A bone marrow aspirate performed for pancytopenia revealed a severely hypoplastic marrow. Fluorescent in situ hybridization (FISH) using X-and Y-chromosome probes demonstrated that 80% of marrow cells were of donor origin. Comparison of Giemsa-stained cell morphology and FISH showed that the erythroid precursor cells were predominantly of male pattern (XY). This report is one of only a few studies that prove the migration of a donor's hematopoietic stem cells to a recipient's bone marrow. We demonstrated that FISH analysis using sex chromosome probes is useful to confirm a diagnosis of GVHD following organ transplantation from a donor of the opposite sex. We also showed that donor hematopoietic stem cells in a liver graft can migrate to the recipient's bone marrow. We suggest that FISH is a rapid and reliable test for confirming the diagnosis of GVHD in a peripheral blood or skin biopsy sample. (J Mol

show abstract

Graft-versus-host disease following living donor liver transplantation

Cited by 50 publications

References 17 publications

Matching donor to recipient in liver transplantation: Relevance in clinical practice

Matching donor to recipient in liver transplantation: Relevance in clinical practice

Correlation of Chimerism with Acute Graft-versus-Host Disease in Rats following Liver Transplantation

FISH Diagnosis of Acute Graft-Versus-Host Disease Following Living-Related Liver Transplant

Contact Info

Product

Resources

About