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Cited 13 time in webofscience Cited 13 time in scopus
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Acute Graft-vs-Host Disease After Liver Transplantation: Experience at a High-volume Liver Transplantation Center in Korea

Authors
Kang W.H.Hwang S.Song G.W.Jung D.H.Park G.C.Ahn C.S.Moon D.B.Kim K.H.Ha T.Y.Kim W.J.Kim S.H.Cho H.D.Kwon J.H.Jwa E.K.Lee S.G.
Issue Date
Dec-2016
Publisher
Elsevier USA
Citation
Transplantation Proceedings, v.48, no.10, pp 3368 - 3372
Pages
5
Indexed
SCI
SCIE
SCOPUS
Journal Title
Transplantation Proceedings
Volume
48
Number
10
Start Page
3368
End Page
3372
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/34540
DOI
10.1016/j.transproceed.2016.08.051
ISSN
0041-1345
1873-2623
Abstract
Background Acute graft-vs-host disease (GVHD) is a rare but life-threatening complication of orthotopic liver transplantation (OLT). We present 6 cases of GVHD after OLT. Methods Among our 4294 OLT recipients, we identified 6 patients (0.14%) who were diagnosed with GVHD. Their medical records were reviewed retrospectively. Results Liver graft types included deceased donor whole liver graft (n = 3) and right liver graft from son (n = 3). Mean recipient and donor ages were 57.2 ± 6.6 years and 32.7 ± 10.8 years, respectively. Onset of GVHD symptoms occurred 14 to 32 days after OLT, and initial symptoms were skin rash (n = 5) and fever (n = 1). GVHD was pathologically confirmed by skin or rectal biopsy. Chimerism of donor lymphocytes was identified in all 3 patients who underwent the short tandem repeat polymerase chain reaction assay. Attempts were made to treat the GVHD in all 6 patients by corticosteroids with or without low-dose calcineurin inhibitor, but we had to stop early or reduce these agents due to aggravation of pancytopenia and septic complications. Ultimately, 5 patients died 6 to 106 days after the onset of GVHD, and only 1 patient recovered. This surviving patient was diagnosed earlier and had been administered the recommended dosage of corticosteroid for a longer period with aggressive infection prophylaxis compared to the other cases. Conclusions Because of very poor outcomes of GVHD after OLT, early diagnosis and vigorous treatment should be emphasized, although no effective treatment modality has been established yet. We strongly suggest performing aggressive infection prophylaxis during GVHD treatment. © 2016 Elsevier Inc.
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Kim, Wan Joon
Guro Hospital (Department of Hepato-Biliary-Pancreatic Surgery, Guro Hospital)
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