Graft versus host disease following liver transplantation: A case report
- Authors:
- Changsong Zhang
- Guangshun Yang
- Yang Ling
- Guihua Chen
- Tianbao Zhou
View Affiliations
Affiliations: Clinical Oncology Laboratory, Changzhou Tumor Hospital, Medical College of Soochow University, Changzhou, Jiangsu 213002, P.R. China, Hepatic Surgery Center, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, P.R. China, Hepatic Surgery Center, The Third Affiliated Hospital, Sun Yat‑sen University, Guangzhou, Guangdong 510630, P.R. China, Hepatobiliary Surgery Center, The Affiliated Ningbo No. 2 Hospital, Ningbo University School of Medicine, Ningbo, Zhejiang 315010, P.R. China
- Published online on: July 17, 2014 https://doi.org/10.3892/etm.2014.1850
-
Pages:
1164-1166
Metrics: Total
Views: 0 (Spandidos Publications: | PMC Statistics: )
Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )
This article is mentioned in:
Abstract
Graft versus host disease (GVHD) is an uncommon complication following liver transplantation. In the present case report, a 53‑year‑old male hepatitis B virus carrier was diagnosed with primary liver cancer with post‑hepatitis cirrhosis. Preoperative cytomegalovirus (CMV), Epstein‑Barr virus, coxsackievirus, herpes simplex virus and autoimmune antibody series were negative. Preoperative human leukocyte antigen type was also negative. Following classic orthotropic liver transplantation, postoperative treatment included immunosuppression therapy, infection protection, anti‑human immunodeficiency virus therapy and CMV infection protection therapy. Chemotherapy was initiated at day 16 following surgery. At day 26 following the transplantation, the patient developed a fever of unknown cause, and a scattered red rash was observed behind the left ear and on the neck. The patient presented with a fever of unknown cause, rash, symptoms of the digestive tract, leukocytopenia and pancytopenia. A diagnosis of GVHD was confirmed following a skin biopsy. Symptomatic therapies, including antivirals, anti‑anaphylaxis drugs and steroids were administered. However, the patient succumbed to infection, acute respiratory distress syndrome and multiple organ failure at day 46 following surgery. Therefore, an effective therapeutic strategy for the treatment of GVHD following liver transplantation is yet to be established, and further research is required prior to such a regimen being developed.
View References
1
|
Thin L, Macquillan G, Adams L, et al:
Acute graft-versus-host disease after liver transplant: novel use
of etanercept and the role of tumor necrosis factor alpha
inhibitors. Liver Transpl. 15:421–426. 2009. View Article : Google Scholar : PubMed/NCBI
|
2
|
Christopeit M, Schütte V, Theurich S,
Weber T, Grothe W and Behre G: Rituximab reduces the incidence of
acute graft-versus-host disease. Blood. 113:3130–3131. 2009.
View Article : Google Scholar : PubMed/NCBI
|
3
|
D’Asaro M, Salerno A, Dieli F and Caccamo
N: Analysis of memory and effector CD8+ T cell subsets
in chronic graft-versus-host disease. Int J Immunopathol Pharmacol.
22:195–205. 2009.
|
4
|
Rezvani AR and Storb RF: Prevention of
graft-vs. -host disease. Expert Opin Pharmacother. 13:1737–1750.
2012. View Article : Google Scholar : PubMed/NCBI
|
5
|
Przepiorka D, Weisdorf D, Martin P,
Klingemann HG, Beatty P, Hows J and Thomas ED: 1994 consensus
conference on acute GVHD grading. Bone Marrow Transplant.
15:825–828. 1995.PubMed/NCBI
|
6
|
Foley JE, Jung U, Miera A, et al: Ex vivo
rapamycin generates donor Th2 cells that potently inhibit
graft-versus-host disease and graft-versus-tumor effects via an
IL-4-dependent mechanism. J Immunol. 175:5732–5743. 2005.
View Article : Google Scholar : PubMed/NCBI
|
7
|
Wilson J, Cullup H, Lourie R, et al:
Antibody to the dendritic cell surface activation antigen CD83
prevents acute graft-versus-host disease. J Exp Med. 206:387–398.
2009. View Article : Google Scholar : PubMed/NCBI
|
8
|
Ratanatharathorn V, Nash RA, Przepiorka D,
et al: Phase III study comparing methotrexate and tacrolimus
(prograf, FK506) with methotrexate and cyclosporine for
graft-versus-host disease prophylaxis after HLA-identical sibling
bone marrow transplantation. Blood. 92:2303–2314. 1998.
|
9
|
Busca A, Saroglia EM, Lanino E, et al:
Mycophenolate mofetil (MMF) as therapy for refractory chronic GVHD
(cGVHD) in children receiving bone marrow transplantation. Bone
Marrow Transplant. 25:1067–1071. 2000. View Article : Google Scholar : PubMed/NCBI
|
10
|
Stewart BL, Storer B, Storek J, et al:
Duration of immunosuppressive treatment for chronic
graft-versus-host disease. Blood. 104:3501–3506. 2004. View Article : Google Scholar : PubMed/NCBI
|