title: Treatment of acute graft-vs-host disease after simultaneous pancreas-kidney transplantation: a case report.
abstract: Whereas neutropenia is common after solid-organ transplantation, graft-vs-host disease is unusual, especially after simultaneous pancreas-kidney transplantation. Most cases reported in the literature give few details of treatment approach, and all were fatal. A 45-year-old man with diabetes underwent simultaneous pancreas-kidney transplantation at our center, with organs from a female donor. Two weeks postoperatively, he was readmitted with fever, malaise, and neutropenia. A bone marrow biopsy specimen demonstrated that two-thirds of the lymphocytes were of female karyotype. Graft-vs-host disease was diagnosed. Aggressive immunosuppression therapy was administered; however, the patient died. To our knowledge, this is the first case report with specific details of a treatment protocol and sequential short tandem repeat data.
authors.affiliation: Kidney and Pancreas Transplant Center, Robert Wood Johnson Medical School, 10 Plum St, 7th Floor, New Brunswick, NJ 08901, USA. adena.osband@rwjuh.edu
authors.forename: A J
authors.initials: AJ
authors.lastname: Osband
authors.forename: D A
authors.initials: DA
authors.lastname: Laskow
authors.forename: R A
authors.initials: RA
authors.lastname: Mann
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D001856:Bone Marrow Examination; D004359:Drug Therapy, Combination; D017809:Fatal Outcome; D005260:Female; D006086:Graft vs Host Disease / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007621:Karyotyping; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation / Q000009:adverse effects*; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents