Graft‐versus‐host disease after liver transplantation is associated with bone marrow failure, hemophagocytosis, and DNMT3A mutations

2021 ◽  
Author(s):  
Laura F. Newell ◽  
Jennifer Dunlap ◽  
Ken Gatter ◽  
Grover C. Bagby ◽  
Richard D. Press ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Liver Transplantation ◽  
Graft Versus Host Disease ◽  
Bone Marrow Failure ◽  
Host Disease ◽  
Graft Versus Host

Orthotopic liver transplantation for graft-versus-host disease following bone marrow transplantation

1990 ◽  
Vol 99 (2) ◽  
pp. 536-538 ◽  
Author(s):  
David F. Rhodes ◽  
William M. Lee ◽  
John R. Wingard ◽  
Michael D. Pavy ◽  
George W. Santos ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Liver Transplantation ◽  
Bone Marrow Transplantation ◽  
Orthotopic Liver Transplantation ◽  
Graft Versus Host Disease ◽  
Marrow Transplantation ◽  
Host Disease ◽  
Graft Versus Host

Solid Organ Transplant-Associated Acute Graft-Versus-Host Disease

2010 ◽  
Vol 134 (8) ◽  
pp. 1220-1224 ◽  
Author(s):  
Yaxia Zhang ◽  
Phillip Ruiz
Keyword(s):  
Bone Marrow ◽  
Graft Versus Host Disease ◽  
Clinical Symptoms ◽  
Bone Marrow Failure ◽  
Organ Transplant ◽  
Solid Organ Transplant ◽  
Solid Organ ◽  
Multisystem Disease ◽  
Host Disease ◽  
Graft Versus Host

Abstract Solid organ transplant–associated graft-versus-host disease is an infrequent and potentially lethal complication. The incidence of this complication varies according to the type of organ transplant with higher rates associated with liver and small bowel transplants. The clinical presentation typically includes fever and skin rash, and most cases quickly advance to become a multisystem disease affecting the bone marrow and other nontransplanted solid organs. The diagnosis is based on the clinical symptoms, pathologic changes in biopsied tissues, and systemic lymphoid chimerism. The mortality of this disease can exceed 75% after liver transplant and most patients die from infections or hemorrhage due to bone marrow failure. There is no standard treatment strategy for this complication, and the management mainly consists of both prophylaxis and immediate treatment without delay. This short review summarizes the current pathogenesis, diagnosis, and treatment of this entity.

scholarly journals Graft-Versus-Host Disease after Liver Transplantation Complicated by Systemic Aspergillosis with Pancarditis

2000 ◽  
Vol 14 (7) ◽  
pp. 637-640 ◽  
Author(s):  
Joseph Romagnuolo ◽  
Laurence D Jewell ◽  
Norman M Kneteman ◽  
Vince G Bain
Keyword(s):  
Bone Marrow ◽  
Liver Transplantation ◽  
Bone Marrow Transplantation ◽  
Skin Rash ◽  
Graft Versus Host Disease ◽  
Marrow Transplantation ◽  
Watery Diarrhea ◽  
Biliary Cirrhosis ◽  
Host Disease ◽  
Graft Versus Host

Acute graft-versus-host disease (GVHD) is a common complication after bone marrow transplantation, with characteristic rash and diarrhea being the most common features. After liver transplantation, however, this phenomenon is very rare. Most transplant patients are on a variety of medications, including immunosuppressants; therefore, the differential diagnosis of skin rash or diarrhea is broad. A 37-year-old man who underwent liver transplantation for primary biliary cirrhosis, and developed a rash and watery diarrhea, is presented. Skin and colonic biopsies confirmed acute GVHD. A pulse of intravenous steroids was given. The skin rash improved, but he developed pancytopenia. His course was complicated by central line infection, jugular and subclavian vein thrombosis, pseudomembranous colitis, recurrent bacteremia, cholestasis on total parenteral nutrition and cytomegalovirus infection. After the onset of pleuritic chest pain and clinical sepsis, spiral computed tomography scan of his chest and abdomen revealed septic infarcts in multiple organs. Despite empirical treatment with amphotericin B, he died of multiorgan dysfunction syndrome within 72 h. Autopsy revealed systemic aspergillosis with pancarditis, endocardial vegetations, and septic pulmonary, splenic, hepatic and renal infarcts. The pathogenesis and experience with this rare, but often fatal, complication of liver transplantation are reviewed. In contrast to GVHD after bone marrow transplantation, pancytopenia is common and liver dysfunction is rare. One should have a high level of suspicion in the liver transplant recipient presenting with rash and/or diarrhea.

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