Year 2016 / Volume 108 / Number 1
Letter to the Editor
Graft versus host disease as a complication after liver transplantation: A rare but serious association

49-50

DOI: 10.17235/reed.2015.3722/2015

Baltasar Pérez Saborido, Enrique Asensio Díaz, Asterio Barrera Rebollo, Mario Rodríguez López, Marta Gonzalo Martín, Beatriz Madrigal Rubiales, Félix García Pajares, David Pacheco Sánchez,

Abstract
The graft versus host disease after liver transplant is rare, with an incidence less than 1%, but with a high mortality (75-85%), especially due to infectious complications. It usually affects gastrointestinal tract, skin and blood system in the context of a normal liver graft function. There is no consensus on the most appropriate treatment: some articles support a reduction or even elimination of immunosuppressive drugs, while others published success with a dose increase. Clinical case. We report a case of a 68 year-old liver transplant recipient with a graft retrieved from an ABO identical cadaveric donor. After an uneventful postoperative period, he was readmitted presenting these symptoms: skin lesions, diarrhea and kidney failure. After ruling out infectious causes or drug toxicity, skin, duodenum and colon biopsies demonstrated characteristic histological changes of graft versus host disease grade III. Initially, supportive treatment along with methylprednisolone bolus were administered with good response. However, as the doses of corticosteroids decreased, the patient worsened again, requiring basiliximab. In spite of that, the patient progressively worsened with hematological involvement and, finally, an alteration of liver function tests prior to decease. The autopsy showed CMV and Herpes virus superinfection. Discussion. We report a new case of graft-versus-host disease after liver transplantation with fatal evolution due to viral superinfection despite the employed measures.
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References
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Pérez Saborido B, Asensio Díaz E, Barrera Rebollo A, Rodríguez López M, Gonzalo Martín M, Madrigal Rubiales B, et all. Graft versus host disease as a complication after liver transplantation: A rare but serious association. 3722/2015


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Publication history

Received: 07/02/2015

Accepted: 17/05/2015

Online First: 05/11/2015

Published: 30/12/2015

Article revision time: 94 days

Article Online First time: 271 days

Article editing time: 326 days


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