J Korean Soc Transplant.  2013 Mar;27(1):15-20. 10.4285/jkstn.2013.27.1.15.

A Case of Acute Graft versus Host Disease after Liver Transplantation

• Lee HJ
• Lee SM
• Kim BC
• Chu CW
• Yang KH
• Ryu JH
• Moon KM
• Choi KU
• Kim HH

• KMID: 1488437
• DOI: http://doi.org/10.4285/jkstn.2013.27.1.15

Abstract

The mortality rate of patients with acute graft versus host disease (GVHD) after liver transplantation is very high. Autoimmune hepatitis and diabetes mellitus (DM) is the risk factors of GVHD. Human leukocyte antigen (HLA)-homozygote donor with one way donor-recipient HLA matching is on the risk of fatal GVHD following living donor liver transplantation (LDLT). If recipient has more than one risk factors of GVHD and is going to LDLT, HLA typing is needed to identify donor-dominant one-way HLA matching and helpful to diagnose and treat early and survival of patient will be improved. We report a case of GVHD after liver transplantation for hepatocellular carcinoma and DM who received an allograft from his HLA-homozygous son.

Keyword

Acute; Graft versus host disease; Liver transplantation; HLA antigens

MeSH Terms

Carcinoma, Hepatocellular
Diabetes Mellitus
Graft vs Host Disease
Hepatitis, Autoimmune
Histocompatibility Testing
HLA Antigens
Humans
Leukocytes
Liver
Liver Transplantation
Living Donors
Risk Factors
Tissue Donors
Transplantation, Homologous
Transplants
HLA Antigens

Figure

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  Fig. 1. Erythematous to violaceous scaly papules and patches on the whole body and acral erythema.

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  Fig. 2. After onset of acute graft versus host diease (GVHD), white blood cell (WBC), and platelet count (PLT) were gradually deceased. Patient died at postoperative day (POD) 52. Abbreviation: OP, operative day.

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  Fig. 3. Direct sequencing of exon 2,3 showing heterozygous pattern of recipient and homozygous pattern. Abbreviation: HLA, human leukocyte antigen.

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