Acute graft versus host disease following living donor liver transplantation: first Korean report.
Graft-versus-host disease (GVHD) after liver transplantation is an uncommon fatal complication and no effective preventive or therapeutic measure is available. We report the first case of fatal GVHD after liver transplantation in Korea. A 51-year-old male underwent living donor liver transplantation for hepatitis B virus (HBV)-related liver cirrhosis and hepatocellular carcinoma. The donor was his 21-year-old son. The patient was discharged uneventfully. However, 56 days after transplantation, he was readmitted due to watery diarrhea, which was subsequently accom-panied by a skin rash and leukopenia. Diagnosis was made by skin biopsy and by donor DNA chimerism testing in recipient tissue. A one-way donor-recipient HLA match was identified by HLA typing for both donor and recipient. The patient was treated by increasing immunosuppression, but died of septic shock. A pretransplant HLA typing of both donor and recipient should be taken, and in cases of one-way donor-recipient HLA matching, liver transplantation should be avoided.
Cho
Eung-Ho
EH
Department of Surgery, Seoul National University, College of Medicine, Seoul, Korea.
Suh
Kyung-Suk
KS
Yang
Sung Hoon
SH
Lee
Hae Won
HW
Cho
Jai Young
JY
Cho
Yong Beom
YB
Yi
Nam-Joon
NJ
Lee
Kuhn Uk
KU
D006528:Carcinoma, Hepatocellular / Q000601:surgery; D003092:Colitis / Q000473:pathology; D003586:Cytomegalovirus Infections / Q000473:pathology; D017809:Fatal Outcome; D006086:Graft vs Host Disease / Q000175:diagnosis / Q000209:etiology* / Q000276:immunology; D006801:Humans; D007723:Korea; D008103:Liver Cirrhosis / Q000601:surgery; D008113:Liver Neoplasms / Q000601:surgery; D016031:Liver Transplantation / Q000009:adverse effects* / Q000276:immunology / Q000379:methods; D019520:Living Donors; D008212:Lymphocyte Depletion; D008297:Male; D008875:Middle Aged; D012772:Shock, Septic / Q000209:etiology