title: [Graft versus host disease after liver transplantation: a report of 3 cases].
abstract: 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.
authors.affiliation: Department of Hepatobiliary and Pancreatic Surgery and Centre of Organ Transplantation, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China.
authors.forename: Ting-bo
authors.initials: TB
authors.lastname: Liang
authors.forename: Xiao-feng
authors.initials: XF
authors.lastname: Tang
authors.forename: Shu-sen
authors.initials: SS
authors.lastname: Zheng
authors.forename: An-wei
authors.initials: AW
authors.lastname: Lu
authors.forename: Wei-lin
authors.initials: WL
authors.lastname: Wang
authors.forename: Yan
authors.initials: Y
authors.lastname: Shen
authors.forename: Min
authors.initials: M
authors.lastname: Zhang
authors.forename: Xue-qin
authors.initials: XQ
authors.lastname: Meng
mesh_terms: 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
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine; D016559:Tacrolimus