When donor T cells attack: The curious case of liver transplant-associated acute graft-versus-host-disease
| Autor: | Max Deschner, Donald J. Bastin, Ziad Solh, Karen Bosma, Wael Haddara, Ping Yang, Robert Broadbent, Aaron Haig, Jonathan Keow, Mayur Brahmania, Anargyros Xenocostas, Uday Deotare |
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| Rok vydání: | 2022 |
| Předmět: | |
| Zdroj: | Science Progress. 105:003685042211170 |
| ISSN: | 2047-7163 0036-8504 |
| Popis: | Graft versus host disease is a rare but deadly complication of solid organ transplant. Clinical features of graft-versus-host-disease are non-specific, which may lead to delayed diagnosis as more common conditions including infections or drug reactions are considered. We describe a 54-year-old male patient who underwent liver transplantation for alcohol use disorder-related cirrhosis and developed acute graft-versus-host disease. Initial clinical presentation included dermatitis, bone marrow failure and enteritis. Results of skin biopsy and cytogenetic studies were consistent with liver transplant-associated acute graft-versus-host disease. The importance of this case is to highlight to transplant physicians and surgeons the challenges of diagnosing graft-versus-host-disease. In our case, pre-existing partnerships among the liver and hematopoietic stem cell transplant teams, transfusion medicine specialists, critical care specialists and facilitated timely communication relevant to confirming graft-versus-host disease. We propose an algorithm to assist in the workup of suspected graft-versus-host disease. Because this condition is characterized by high mortality, a high index of suspicion is imperative for prompt diagnosis and optimal management of the donor-recipient immune interaction when patients present with classic clinical features. |
| Databáze: | OpenAIRE |
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