title: Graft versus host disease following liver transplantation: A case report.
abstract: Graft versus host disease (GVHD) is an uncommon complication following liver transplantation. In the present case report, a 53-year-old male hepatitis B virus carrier was diagnosed with primary liver cancer with post-hepatitis cirrhosis. Preoperative cytomegalovirus (CMV), Epstein-Barr virus, coxsackievirus, herpes simplex virus and autoimmune antibody series were negative. Preoperative human leukocyte antigen type was also negative. Following classic orthotropic liver transplantation, postoperative treatment included immunosuppression therapy, infection protection, anti-human immunodeficiency virus therapy and CMV infection protection therapy. Chemotherapy was initiated at day 16 following surgery. At day 26 following the transplantation, the patient developed a fever of unknown cause, and a scattered red rash was observed behind the left ear and on the neck. The patient presented with a fever of unknown cause, rash, symptoms of the digestive tract, leukocytopenia and pancytopenia. A diagnosis of GVHD was confirmed following a skin biopsy. Symptomatic therapies, including antivirals, anti-anaphylaxis drugs and steroids were administered. However, the patient succumbed to infection, acute respiratory distress syndrome and multiple organ failure at day 46 following surgery. Therefore, an effective therapeutic strategy for the treatment of GVHD following liver transplantation is yet to be established, and further research is required prior to such a regimen being developed.
authors.affiliation: Clinical Oncology Laboratory, Changzhou Tumor Hospital, Medical College of Soochow University, Changzhou, Jiangsu 213002, P.R. China.
authors.forename: Changsong
authors.initials: C
authors.lastname: Zhang
authors.affiliation: Hepatic Surgery Center, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, P.R. China.
authors.forename: Guangshun
authors.initials: G
authors.lastname: Yang
authors.affiliation: Clinical Oncology Laboratory, Changzhou Tumor Hospital, Medical College of Soochow University, Changzhou, Jiangsu 213002, P.R. China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Ling
authors.affiliation: Hepatic Surgery Center, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510630, P.R. China.
authors.forename: Guihua
authors.initials: G
authors.lastname: Chen
authors.affiliation: Hepatobiliary Surgery Center, The Affiliated Ningbo No. 2 Hospital, Ningbo University School of Medicine, Ningbo, Zhejiang 315010, P.R. China.
authors.forename: Tianbao
authors.initials: T
authors.lastname: Zhou
keywords: graft versus host disease; liver transplantation