Treatment of Acute Graft-versus-Host Disease in Liver Transplant Recipients.

Autor: Kim E; Department of Surgery, UMass Memorial Medical Center, Worcester, MA, USA., Adeel A; Department of Medicine, Division of Infectious Diseases & Immunology, UMass Memorial Medical Center, Worcester, MA, USA., Bozorgzadeh A; Department of Surgery, Division of Organ Transplantation, UMass Memorial Medical Center, Worcester, MA, USA., Amano S; Department of Pathology, UMass Memorial Medical Center, Worcester, MA, USA., Barry CT; Department of Medicine, Division of Gastroenterology, UMass Memorial Medical Center, Worcester, MA, USA., Daly JS; Department of Medicine, Division of Infectious Diseases & Immunology, UMass Memorial Medical Center, Worcester, MA, USA., Devuni D; Department of Medicine, Division of Gastroenterology, UMass Memorial Medical Center, Worcester, MA, USA., Elaba Z; Department of Pathology, UMass Memorial Medical Center, Worcester, MA, USA., Houk L; Department of Dermatology, UMass Memorial Medical Center, Worcester, MA, USA., Martins PN; Department of Surgery, Division of Organ Transplantation, UMass Memorial Medical Center, Worcester, MA, USA., Movahedi B; Department of Surgery, Division of Organ Transplantation, UMass Memorial Medical Center, Worcester, MA, USA., Ramanathan M; Department of Medicine, Division of Hematology and Oncology, UMass Memorial Medical Center, Worcester, MA, USA., Theodoropoulos NM; Department of Medicine, Division of Infectious Diseases & Immunology, UMass Memorial Medical Center, Worcester, MA, USA.
Jazyk: angličtina
Zdroj: Case reports in transplantation [Case Rep Transplant] 2021 Nov 30; Vol. 2021, pp. 8981429. Date of Electronic Publication: 2021 Nov 30 (Print Publication: 2021).
DOI: 10.1155/2021/8981429
Abstrakt: Acute graft-versus-host disease (aGvHD) is a rare complication of liver transplantation associated with high morbidity and mortality. Death typically occurs due to complications related to severe infection, shock, and multiorgan failure. The clinical presentation involves dysfunction of multiple organ systems with overlapping symptoms that often results in a diagnostic delay. As there are a limited number of cases reported in the literature, there are no clear guidelines for treatment. Many different therapeutic measures have been utilized that target various immune system pathways, but steroids remain the first line of therapy. We report on two patients who developed aGvHD after liver transplantation who were treated with ruxolitinib, a novel Janus kinase 1/2 (JAK) inhibitor that has been shown to improve outcomes in steroid refractory cases of aGvHD after allogenic hematopoietic stem cell transplantation. We reviewed the literature to discuss various therapeutic options currently available for aGvHD after liver transplantation.
Competing Interests: The authors declare no conflict of interest.
(Copyright © 2021 Edward Kim et al.)
Databáze: MEDLINE
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