[Graft versus host disease after liver transplantation: a report of 3 cases].
OBJECTIVE
To document the clinical experience in the diagnosis and treatment of graft-versus-host disease(GVHD) after liver transplantation.


METHODS
Clinical course was followed up and laboratory examinations were done in 3 patients with orthotopic liver transplantation (OLT) who developed acute GVHE. The diagnosis depended on clinical manifestations, skin biopsy, HLA typing and PCR short tandem repeat (PCR-STR). Immunosuppressive drugs were transferred and adjusted.


RESULTS
Fever, shin rash, diarrhea and pancytopenia were found within 3 to 8 weeks after liver transplantation. The liver function was normal. CMV antigen (pp65) and EBV antibody (IgM) were negative. The donor's HLA was detected in the host's peripheral blood cells. One female recipient had the donor's Y chromosome microchimerism detected by PCR-STR. All 3 patients died from infection, alimentary tract bleeding, or multiple organ failure in the end.


CONCLUSIONS
GVHD is not a rare complication easily misdiagnosed with pessimism out come after liver transplantation.
Liang
Ting-bo
TB
Department of Hepatobiliary and Pancreatic Surgery and Centre of Organ Transplantation, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China.
Tang
Xiao-feng
XF
Zheng
Shu-sen
SS
Lu
An-wei
AW
Wang
Wei-lin
WL
Shen
Yan
Y
Zhang
Min
M
Meng
Xue-qin
XQ
D016572:Cyclosporine / Q000627:therapeutic use; D004890:Erythema / Q000209:etiology / Q000628:therapy; D017809:Fatal Outcome; D005260:Female; D005334:Fever / Q000209:etiology / Q000628:therapy; D006086:Graft vs Host Disease / Q000209:etiology* / Q000628:therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016031:Liver Transplantation / Q000009:adverse effects* / Q000379:methods; D008297:Male; D008875:Middle Aged; D010198:Pancytopenia / Q000209:etiology / Q000628:therapy; D016133:Polymerase Chain Reaction; D011379:Prognosis; D012867:Skin / Q000473:pathology; D016559:Tacrolimus / Q000627:therapeutic use
D007166:Immunosuppressive Agents; D016572:Cyclosporine; D016559:Tacrolimus