Orthotopic liver transplantation for graft-versus-host disease following bone marrow transplantation.
Chronic graft-vs.-host disease occurs in 30%-50% of long-term survivors of allogeneic bone marrow grafts, and may eventuate in cirrhosis. In this study, a young woman, originally diagnosed as having acute myelogenous leukemia, underwent successful bone marrow transplantation but later developed graft-vs.-host disease-induced cirrhosis and recurrent variceal hemorrhage. She underwent successful orthotopic liver transplant. Her postoperative course was uncomplicated, with no evidence of rejection or recurrence of graft-vs.-host disease. As bone marrow transplantation is more widely used and survival improves, the number of patients with graft-vs.-host disease or venoocclusive disease resulting in cirrhosis is likely to increase. Hepatic transplantation should be considered for bone marrow transplant patients who develop end-stage liver disease.
Rhodes
D F
DF
Department of Medicine, Medical University of South Carolina, Charleston.
Lee
W M
WM
Wingard
J R
JR
Pavy
M D
MD
Santos
G W
GW
Shaw
B W
BW
Wood
R P
RP
Sorrell
M F
MF
Markin
R S
RS
D000328:Adult; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D004932:Esophageal and Gastric Varices / Q000209:etiology; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006086:Graft vs Host Disease / Q000209:etiology / Q000601:surgery*; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000601:surgery; D008103:Liver Cirrhosis / Q000209:etiology; D016031:Liver Transplantation