Graft-versus-host disease following living donor liver transplantation

Yuji Soejima, Mitsuo Shimada, Taketoshi Suehiro, Shoji Hiroshige, Hisashi Gondo, Akiyoshi Takami, Shizuka Yasue, Yoshihiko Maehara

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

Graft-versus-host disease (GVHD) is the most common and well-known cause of morbidity and mortality following allogeneic bone marrow transplantation. Sporadic cases have been reported after cadaveric donor liver transplantation with usually fatal outcomes, however, the actual incidence and the characteristics of GVHD after living donor liver transplantation (LDLT) remain unknown. We herein report a person who developed fatal GVHD following LDLT and discuss the applicability of an HLA-homozygons donor to an HLA-haploidentical recipient. A 48-year-old male underwent LDLT for unresectable hepatocellular carcinoma with alcoholic liver cirrhosis. The donor was his 20-year-old son whose pretransplant HLA typing was homozygous at all loci. GVHD occurred 35 days after LDLT and was characterized by fever, diarrhea, maculopapular rash, and leukopenia, which led to the development of fatal pneumonia. We identified 4 cases of GVHD after LDLT in Japan and 1 in the United States, all associated with the use of an HLA-homozygous donor. The use of an HLA homozygous donor which results in a complete 1-way donor-recipient HLA match carries an extremely high risk of developing GVHD after LDLT. Therefore, it is possible that LDLT should be ruled out for such donors. A pretransplant work-up of the HLA type in both the donors and recipients is therefore imperative before determining the indications for LDLT.

Original languageEnglish
Pages (from-to)460-464
Number of pages5
JournalLiver Transplantation
Volume10
Issue number3
DOIs
Publication statusPublished - Mar 1 2004

Fingerprint

Living Donors
Graft vs Host Disease
Liver Transplantation
Tissue Donors
Alcoholic Liver Cirrhosis
Histocompatibility Testing
Fatal Outcome
Homologous Transplantation
Leukopenia
Exanthema
Bone Marrow Transplantation
Nuclear Family
Hepatocellular Carcinoma
Diarrhea
Pneumonia
Japan
Fever
Morbidity
Mortality
Incidence

All Science Journal Classification (ASJC) codes

  • Surgery
  • Hepatology
  • Transplantation

Cite this

Soejima, Y., Shimada, M., Suehiro, T., Hiroshige, S., Gondo, H., Takami, A., ... Maehara, Y. (2004). Graft-versus-host disease following living donor liver transplantation. Liver Transplantation, 10(3), 460-464. https://doi.org/10.1002/lt.20101

Graft-versus-host disease following living donor liver transplantation. / Soejima, Yuji; Shimada, Mitsuo; Suehiro, Taketoshi; Hiroshige, Shoji; Gondo, Hisashi; Takami, Akiyoshi; Yasue, Shizuka; Maehara, Yoshihiko.

In: Liver Transplantation, Vol. 10, No. 3, 01.03.2004, p. 460-464.

Research output: Contribution to journalArticle

Soejima, Y, Shimada, M, Suehiro, T, Hiroshige, S, Gondo, H, Takami, A, Yasue, S & Maehara, Y 2004, 'Graft-versus-host disease following living donor liver transplantation', Liver Transplantation, vol. 10, no. 3, pp. 460-464. https://doi.org/10.1002/lt.20101
Soejima Y, Shimada M, Suehiro T, Hiroshige S, Gondo H, Takami A et al. Graft-versus-host disease following living donor liver transplantation. Liver Transplantation. 2004 Mar 1;10(3):460-464. https://doi.org/10.1002/lt.20101
Soejima, Yuji ; Shimada, Mitsuo ; Suehiro, Taketoshi ; Hiroshige, Shoji ; Gondo, Hisashi ; Takami, Akiyoshi ; Yasue, Shizuka ; Maehara, Yoshihiko. / Graft-versus-host disease following living donor liver transplantation. In: Liver Transplantation. 2004 ; Vol. 10, No. 3. pp. 460-464.
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