Fatal Graft-Versus-Host Disease Following Adult-To-Adult Living Donor Liver Transplantation From an HLA Nonhomozygous Donor
- Authors
- Yu, Young-Dong; Kim, Dong-Sik; Ha, Neul; Jung, Sung-Won; Han, Jae-Hyun; Kim, Joo-Young; Park, Sung-Hwan; Cho, Yun-Jung
- Issue Date
- 12월-2016
- Publisher
- SAGE PUBLICATIONS INC
- Keywords
- graft-versus-host disease; living donor liver transplantation; human leukocyte antigen; nonhomozygous; transplant donor; related body regions
- Citation
- PROGRESS IN TRANSPLANTATION, v.26, no.4, pp.394 - 396
- Indexed
- SCIE
SCOPUS
- Journal Title
- PROGRESS IN TRANSPLANTATION
- Volume
- 26
- Number
- 4
- Start Page
- 394
- End Page
- 396
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/86678
- DOI
- 10.1177/1526924816664087
- ISSN
- 1526-9248
- Abstract
- The use of a human leukocyte antigen (HLA) homozygous donor to a haploidentical recipient is a well-documented cause of transfusion-associated graft-versus-host disease (GVHD). Several authors have reported that use of a graft from an HLA-homozygous donor with 1-way donor-recipient HLA matching led to an extremely high risk of developing GVHD in LDLT. We have experienced a fatal case of acute GVHD following adult-to-adult LDLT from a donor who was heterozygous at a single HLA locus. A 53-year-old female underwent LDLT for chronic hepatitis B and recurrent hepatocellular carcinoma. The donor was her 23-year-old son. The HLA phenotype of the donor was not homozygous (A24, -; B54, -; DR4, 9) and revealed one-way donor-dominant HLA matching at two loci with the recipient (A2, 24; B48, 54; DR4, 12). On the fortieth postoperative day, the patient showed erythematous skin lesions. Skin biopsy revealed typical findings of GVHD. Donor-derived chimerism was demonstrated by performing fluorescent in situ hybridization (FISH) using the recipient's skin tissue. As the clinical course deteriorated, etanercept was started in addition to broad-spectrum antibiotics but there was no improvement. As multi-organ failure progressed, the patient succumbed to death on the 54th postoperative day, which was 2 weeks after onset of GVHD. The prevention of GVHD is more important since the results of treatment have been disappointing. We have experienced a fatal case of acute GVHD following adult-to-adult LDLT from a HLA non-homozygous donor. HLA heterozygosity at a single locus does not preclude the possibility of developing GVHD following adult-to-adult LDLT.
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Collections - College of Medicine > Department of Medical Science > 1. Journal Articles
- Graduate School > Department of Biomedical Sciences > 1. Journal Articles
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