Rash and pancytopenia as initial manifestations of acute graft-versus-host disease after liver transplantation

Whalen, Jason G.; Jukic, D.M.; English, Joseph C.

doi:10.1016/j.jaad.2005.01.126

Cited by 29 publications

(21 citation statements)

References 31 publications

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“…Temporal symptomatic control may be achieved by administrating corticosteroids, but resolution of GVHD cannot be expected in most cases. Some authors focus on increasing immunosuppression, addition of antibody preparations such as OKT3, and antithymocyte globulin to eliminate the donor lymphocytes (22)(23)(24). The response to therapy, however, is unpredictable.…”

Section: Discussionmentioning

confidence: 99%

Graft-Versus-Host Disease After Intestinal and Multivisceral Transplantation

et al. 2011

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Section: Discussionmentioning

confidence: 99%

Graft-Versus-Host Disease After Intestinal and Multivisceral Transplantation

et al. 2011

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“…Fever and skin rash are the most frequent early sign followed by leucopenia [23]. Bone marrow involvement, severe sepsis and gastrointestinal bleeding are the major causes of death [5].…”

Section: Clinical Sign and Symptomsmentioning

confidence: 99%

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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“…Manifestations include skin rash, fever, cytopenia, and diarrhea, which is due to infiltration of intestinal mucosa by donor lymphocytes. There is characteristic sparing of the liver as it is of donor origin and lacks the host antigens [210].…”

Section: Graft Versus Host Disease (Gvhd)mentioning

confidence: 99%

“…Presence of chimerism alone is not sufficient, as the test lacks sensitivity and specificity. Chimerism of 3% has been reported in peripheral blood of normal posttransplant patients, while at the same time a number of cases of GVHD lacked chimerism [210,212]. A newly described diagnostic technique, more sensitive than chimerism, consists of application of short tandem repeat assay to detect donor DNA from the affected specimen [213].…”

Section: Graft Versus Host Disease (Gvhd)mentioning

confidence: 99%

Avoiding Pitfalls: What an Endoscopist Should Know in Liver Transplantation—Part II

et al. 2008

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Over the last decade the number of patients undergoing transplantation has increased. At the same time, effective peri- and postoperative care and better surgical techniques have resulted in greater numbers of recipients achieving long-term survival. Identification and effective management in the form of adequate treatment is essential, since any delay in diagnosis or treatment may result in graft loss or serious threat to patient's life. Various aspects of endoscopic findings that can be commonly encountered among liver transplant recipients are discussed herein. Topics include: persistent and/or recurrent esophageal varices, reflux, Candida or cytomegalovirus (CMV) esophagitis, esophageal neoplasms, posttransplant peptic ulcer, biliary complications, posttransplant lymphoproliferative disorder (PTLD), Kaposi's sarcoma, CMV colitis and inflammatory bowel disease, colonic neoplasms, Clostridium difficile infection, and graft versus host disease (GVHD).

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Rash and pancytopenia as initial manifestations of acute graft-versus-host disease after liver transplantation

Cited by 29 publications

References 31 publications

Graft-Versus-Host Disease After Intestinal and Multivisceral Transplantation

Graft-Versus-Host Disease After Intestinal and Multivisceral Transplantation

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

Avoiding Pitfalls: What an Endoscopist Should Know in Liver Transplantation—Part II

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