title: Graft-versus-host disease after orthotopic liver transplantation: multivariate analysis of risk factors.
abstract: Graft-versus-host disease (GVHD) is a rare, fatal complication following orthotopic liver transplantation (OLT). To date, several risk factors have been proposed, but reports on these factors have been inconclusive. This is a retrospective, case-control study of prospectively collected data from 2775 OLTs performed at our institution. Eight cases of GVHD after OLT were diagnosed on the basis of the patient's clinical characteristics, and the findings were confirmed with skin and colonic biopsies. Each case was matched to three controls based on the diagnosis of liver disease, recipient's age, and blood group. Univariate and multivariate analyses were performed to identify risk factors associated with the development of GVHD after OLT. The univariate and multivariate analyses identified two main risk factors associated with development of GVHD in OLT recipients, a difference between recipient and donor age of >20 yr, and any human leukocyte antigen class I matches. Taking these two risk factors into consideration while matching prospective donors and recipients may reduce further incidence of GVHD in OLT patients. However, further studies are recommended to validate these findings.
authors.affiliation: Department of Transplant Medicine, Mayo Clinic, Jacksonville, FL, USA.|Department of Tropical Medicine and Hepatology, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
authors.forename: Mohamed A
authors.initials: MA
authors.lastname: Elfeki
authors.affiliation: Department of Transplant Medicine, Mayo Clinic, Jacksonville, FL, USA.
authors.forename: Surakit
authors.initials: S
authors.lastname: Pungpapong
authors.affiliation: Department of Laboratory Medicine and Pathology, Mayo Clinic, Jacksonville, FL, USA.
authors.forename: Petrina V
authors.initials: PV
authors.lastname: Genco
authors.affiliation: Department of Laboratory Medicine and Pathology, Mayo Clinic, Jacksonville, FL, USA.
authors.forename: Raouf E
authors.initials: RE
authors.lastname: Nakhleh
authors.affiliation: Division of Transplant Surgery, Mayo Clinic, Jacksonville, FL, USA.
authors.forename: Justin H
authors.initials: JH
authors.lastname: Nguyen
authors.affiliation: Department of Transplant Medicine, Mayo Clinic, Jacksonville, FL, USA.
authors.forename: Denise M
authors.initials: DM
authors.lastname: Harnois
mesh_terms: D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D008107:Liver Diseases / Q000150:complications* / Q000601:surgery; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index
keywords: graft-versus-host disease; human leukocytic antigen; multivariate analysis; orthotopic liver transplantation