Graft versus Host Disease in Liver Transplant Recipients: A Case Series
Cleveland Clinic Florida, Weston, FL
Meeting: 2020 American Transplant Congress
Abstract number: A-157
Keywords: Glucocortocoids, Immunosuppression, Liver transplantation, Outcome
Session Name: Poster Session A: Liver Retransplantation and Other Complications
Session Type: Poster Session
Date: Saturday, May 30, 2020
Session Time: 3:15pm-4:00pm
Presentation Time: 3:30pm-4:00pm
*Purpose: Graft Versus Host Disease (GvHD) is a serious and potentially fatal disease that is rarely observed in solid organ transplant recipients; however, we report a case series of five liver transplant recipients who developed GvHD.
*Methods: Medical records of five liver transplant recipients were reviewed. The following information was collected: sex, age, date of transplant, cause of liver disease, use of induction at the time of transplant, time from transplant to diagnosis of GvHD, symptoms, immunosuppression regimen at the time of diagnosis, treatment, and outcome.
*Results: Of the five patients reviewed, the majority of the patients were male (n=4). The median time to GvHD onset was 36 days from transplant. Common GvHD manifestations included rash (n=5), fever (n=3), pancytopenia (n=2), mouth sores (n=2), and diarrhea (n=2). Typical treatment regimens for patients with GvHD included high dose methylprednisolone and anti-thymocyte globulin. Patients with refractory GvHD were also treated with basiliximab and infliximab. Three of the five patients recovered. The remaining two patients died from intracranial hemorrhage.
*Conclusions: The majority of patients who had developed GvHD at our center developed symptoms early in their post-transplant course. We found that high dose steroids, which are the mainstay treatment for GvHD, appeared to be ineffective in our patient population; however, the addition of anti-thymocyte globulin was effective in 60% (n=3) of the cases. This information will be utilized in the management of GvHD in liver transplant recipients at our institution in the future.
To cite this abstract in AMA style:Joiner N, Dietz J, Nava-Estevanott K, Kerbe L. Graft versus Host Disease in Liver Transplant Recipients: A Case Series [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/graft-versus-host-disease-in-liver-transplant-recipients-a-case-series/. Accessed March 26, 2023.
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