scholarly journals Graft-versus-Host Disease after Living-Unrelated Kidney Transplantation

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
N. Zacharias ◽  
M. H. Gallichio ◽  
D. J. Conti
Keyword(s):  
Kidney Transplantation ◽  
Graft Versus Host Disease ◽  
Rare Complication ◽  
Solid Organ Transplantation ◽  
Solid Organ ◽  
Intravenous Hyperalimentation ◽  
Host Disease ◽  
Graft Versus Host ◽  
Work Up ◽  
Host Tissues

Graft-versus-host disease (GVHD) is a rare complication after solid organ transplantation and consists of a reaction of donor derived immune cells directed against host tissues. The vast majority of cases reported in the literature involve liver, small intestine and pancreas transplantation. We report a case of GVHD in a 48-year-old man after living-unrelated kidney transplantation at another center. Six months postoperatively he developed a skin rash, anorexia, and diarrhea that resulted in malnutrition and a 90 pound weight loss. At this point he was transferred to our center with a BMI of 16 and severe cachexia. Intravenous hyperalimentation was initiated and an extensive work-up for an infectious etiology was performed and was negative. An esophagogastroduodenoscopy was performed and revealed nodularity of the gastric mucosa, atrophy, and edema in the first and second portion of his duodenum. Biopsy findings were consistent with GVHD. Aggressive immunosuppressive therapy was instituted with a good response. The anorexia and diarrhea resolved, and he was discharged on hospital day 20. Three months later, there had been no recurrence of the diarrhea, the patient had gained an additional 40 pounds, BMI of 25, and a repeat upper endoscopy revealed complete resolution of the initial endoscopic abnormalities.

Graft-Versus-Host Disease in Solid Organ Transplantation

Graft ◽  
2001 ◽  
Vol 4 (3) ◽  
pp. 205-208 ◽  
Author(s):  
Michael J. Hanaway ◽  
Joseph F. Buell ◽  
Alexandru I. Musat ◽  
Munci Kalayoglu
Keyword(s):  
Organ Transplantation ◽  
Graft Versus Host Disease ◽  
Solid Organ Transplantation ◽  
Solid Organ ◽  
Host Disease ◽  
Graft Versus Host

The use of ruxolitinib for acute graft‐versus‐host disease developing after solid organ transplantation

2019 ◽  
Vol 20 (2) ◽  
pp. 589-592 ◽  
Author(s):  
Miriam T. Jacobs ◽  
Marissa Olson ◽  
Bruna Pellini Ferreira ◽  
Ramon Jin ◽  
Ramsey Hachem ◽  
...  
Keyword(s):  
Organ Transplantation ◽  
Graft Versus Host Disease ◽  
Solid Organ Transplantation ◽  
Solid Organ ◽  
Host Disease ◽  
Graft Versus Host ◽  
Acute Graft

Graft-versus-host disease in solid organ transplantation

1991 ◽  
Vol 4 (2) ◽  
pp. 67-71 ◽  
Author(s):  
Neville V. Jamieson ◽  
Valerie Joysey ◽  
Peter J. Friend ◽  
Robert Marcus ◽  
Sheila Ramsbottom ◽  
...  
Keyword(s):  
Organ Transplantation ◽  
Graft Versus Host Disease ◽  
Solid Organ Transplantation ◽  
Solid Organ ◽  
Host Disease ◽  
Graft Versus Host

scholarly journals Graft Versus Host Disease

1970 ◽  
Vol 11 (2) ◽  
Author(s):  
Janeve Desy MD ◽  
Marc Deschenes MD
Keyword(s):  
Liver Transplantation ◽  
Graft Versus Host Disease ◽  
Rare Complication ◽  
Organ Transplant ◽  
Maculopapular Rash ◽  
Solid Organ Transplant ◽  
Hla Typing ◽  
Solid Organ ◽  
Host Disease ◽  
Graft Versus Host

Graft Versus Host Disease (GVHD) is a rare complication of liver transplantation with a mortality rate exceeding 65%. A 53-year-old male presented with a diffuse maculopapular rash, diarrhea, lymphopenia, fever, and confusion 14 days after orthotopic liver transplantation for hepatitis B cirrhosis. Skin biopsy and HLA- typing of peripheral blood confirmed a diagnosis of solid organ transplant related GVHD. This report summarizes what is known about this disease and emphasizes the importance of early diagnosis, which is one of the only factors known to improve the mortality of this deadly condition.

The infusion of ex vivo activated and expanded CD4+CD25+ immune regulatory cells inhibits graft-versus-host disease lethality

Blood ◽  
2002 ◽  
Vol 99 (10) ◽  
pp. 3493-3499 ◽  
Author(s):  
Patricia A. Taylor ◽  
Christopher J. Lees ◽  
Bruce R. Blazar
Keyword(s):  
T Cells ◽  
Graft Versus Host Disease ◽  
Cellular Therapy ◽  
Ex Vivo ◽  
Solid Organ Transplantation ◽  
Solid Organ ◽  
Host Disease ◽  
Graft Versus Host ◽  
In Vivo Animal Model

Immune regulatory CD4+CD25+ cells play a vital role in the induction and maintenance of self-tolerance and the prevention of autoimmunity. Recently, CD4+CD25+ cells have been shown to be required for the ex vivo induction of tolerance to alloantigen via costimulatory blockade and to inhibit allogeneic skin graft rejection. Data presented here demonstrate that CD4+CD25+ cells play an important role in graft-versus-host disease (GVHD) generation. Depletion of CD4+CD25+ cells from the donor T-cell inoculum or in vivo CD25-depletion of the recipient before transplantation resulted in increased GVHD mediated by CD4+or whole T cells in several strain combinations irrespective of the total body irradiation conditioning regime. The infusion of freshly purified donor CD4+CD25+ cells modestly inhibited GVHD when administered in equal numbers with whole CD4+ cells. Because CD4+CD25+ cells only account for 5% to 10% of the total CD4+ population, the administration of high numbers of fresh donor CD4+CD25+ cells may not be clinically practical. However, we found that large numbers of CD4+CD25+ cells can be obtained by ex vivo activation and expansion. Cultured CD4+CD25+ cells, administered in equal numbers with CD4+ T cells or CD25-depleted whole T cells, resulted in significant inhibition of rapidly lethal GVHD. To our knowledge, this study is the first to demonstrate that activated, cultured CD4+CD25+ cells can offer substantial protection in a relevant in vivo animal model of disease. These data have important ramifications for clinical bone marrow and solid organ transplantation. CD4+CD25+ cells warrant consideration as an exciting new modality of cellular therapy for the inhibition of undesirable autologous and allogeneic responses.

scholarly journals Solid-Organ Graft-Versus-Host Disease After Liver Transplant: A Case Report

2016 ◽  
Vol 36 (3) ◽  
pp. e7-e11 ◽  
Author(s):  
Jonathan S. Auerbach ◽  
Christopher K. Schott
Keyword(s):  
Liver Transplant ◽  
Graft Versus Host Disease ◽  
Rare Complication ◽  
Organ Transplant ◽  
Signs And Symptoms ◽  
High Dose ◽  
Solid Organ ◽  
Host Disease ◽  
Graft Versus Host ◽  
Evidence Based Guidelines

Solid-organ transplant graft-versus-host disease (SOT-GVHD) is a rare complication of organ transplant that is associated with high mortality. The initial signs and symptoms are vague, so this disease is easily confused with other posttransplant complications. A case of SOT-GVHD occurred after orthotopic liver transplant for liver failure due to hepatitis C in a patient in a Veterans Affairs intensive care unit. The patient had dehydration, acute kidney injuries, rashes, diarrhea, and pancytopenia. Results of skin biopsy, bone marrow biopsy, and cytogenetic studies were consistent with SOT-GVHD. Despite supportive care including antibiotics, antiviral and antifungal therapy, high-dose steroids, antithymoglobulin and neupogen, the patient died of overwhelming sepsis. Owing to the rarity of SOT-GVHD, no evidence-based guidelines or recommendations for treatment exist. Treatment includes high-dose corticosteroids and antibiotic, antifungal, and antiviral prophylaxis. Treatment of liver transplant–related GVHD with anti–tumor necrosis factor a agents has been successful.

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