title: Graft-versus-host disease in paediatric solid organ transplantation: A review of the literature.
abstract: GvHD is a rare and serious complication of organ transplantation. The literature is sparse following solid organ transplantation. The aim of this report was to review the literature of GvHD in paediatric solid organ transplantation. We searched PubMed for English-language full-text manuscripts between 1990 and 2015 for eligible studies. A total of 28 publications were found pertaining to paediatric GvHD following solid organ transplantation. GvHD had a mean incidence of 11% (range 8.3-13.4%) following SBTx and 1.5% following liver transplantation. Where described, the most common sites for presentation of GvHD were the skin (87%), the native GI tract (43%), the lungs (7%), the eyes (4%), HA (4%), and the kidneys (1%). Diagnosis was confirmed with biopsy (93%) and/or chimerism (41%). Treatments used include steroids (80%), of which 75% showed partial or complete resolution. Mortality was 33.3% (range 0-100%). Novel therapies include ECP and MSC therapy. GvHD is a rare but serious disease with high mortality. Novel therapies may offer hope in the future, but currently there is limited evidence for their efficacy in the context of intestinal or liver transplantation.
authors.affiliation: King's College London - GKT School of Medical Education, London, UK.
authors.forename: Thomas
authors.initials: T
authors.lastname: Green
authors.affiliation: King's College Hospital - Paediatric Liver, GI and Nutrition Centre, London, UK.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Hind
mesh_terms: D002648:Child; D006086:Graft vs Host Disease / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015994:Incidence; D045164:Mesenchymal Stem Cell Transplantation; D016377:Organ Transplantation; D010372:Pediatrics; D017893:Photopheresis; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D012307:Risk Factors; D013256:Steroids / Q000627:therapeutic use
chemical_list: D007166:Immunosuppressive Agents; D013256:Steroids
keywords: graft-versus-host disease; intestinal transplantation; liver transplantation; liver/intestine transplant; pediatric transplantation; transplant