지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2010.12
- 수록면
- 235 - 240 (6page)
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Purpose: Graft-Versus-Host Disease (GVHD) is a rare (0.1∼2%) but severe complication after liver transplantation (LT). It is the most lethal complication after LT and there are currently no effective preventive or therapeutic measures available. Approximately 90 such cases have been reported in the literature, but only one case has been reported in Korea.
Methods: We performed a retrospective analysis of 767 patients who underwent LT (living donor : deceased donor=554 : 213) at Seoul National University Hospital, Korea from 1998 to 2009. Four patients (4/767, 0.52%) with histologically proven GVHD were found. The diagnosis of GVHD was made according to observing macrochimerism in the peripheral blood and the affected tissue biopsy.
Results: Four patients underwent LT due to Hepatitis B virus-related liver cirrhosis and two of these patients had coexisting hepatocellular carcinoma. Three patients received livers from deceased donors and one received a liver from a live donor. All their blood matching were identical. The first diagnosed case underwent human leukocyte antigen (HLA) typing only after LT and it showed complete one-way donor-recipient HLA matching. The onset of GVHD occurred between 10 days and 55 days after LT. All the patients developed high-grade fever, skin rash, neutropenia, diarrhea and the main signs and symptoms related to GVHD. All the patients died because of sepsis despite intensive treatment.
Conclusion: GVHD after LT is an extremely rare and fatal complication and it is difficult to diagnose. Therefore, we should perform pre-transplant HLA matching and try to establish an early diagnosis for patients who are clinical suspicious of having GVHD. Further study in this area is needed and physicians need to be alert to detect this malady.
Methods: We performed a retrospective analysis of 767 patients who underwent LT (living donor : deceased donor=554 : 213) at Seoul National University Hospital, Korea from 1998 to 2009. Four patients (4/767, 0.52%) with histologically proven GVHD were found. The diagnosis of GVHD was made according to observing macrochimerism in the peripheral blood and the affected tissue biopsy.
Results: Four patients underwent LT due to Hepatitis B virus-related liver cirrhosis and two of these patients had coexisting hepatocellular carcinoma. Three patients received livers from deceased donors and one received a liver from a live donor. All their blood matching were identical. The first diagnosed case underwent human leukocyte antigen (HLA) typing only after LT and it showed complete one-way donor-recipient HLA matching. The onset of GVHD occurred between 10 days and 55 days after LT. All the patients developed high-grade fever, skin rash, neutropenia, diarrhea and the main signs and symptoms related to GVHD. All the patients died because of sepsis despite intensive treatment.
Conclusion: GVHD after LT is an extremely rare and fatal complication and it is difficult to diagnose. Therefore, we should perform pre-transplant HLA matching and try to establish an early diagnosis for patients who are clinical suspicious of having GVHD. Further study in this area is needed and physicians need to be alert to detect this malady.
목차
Introduction
Methods
Results
Discussion
References
참고문헌 (20)
참고문헌 신청
1. [학술지(정기간행물)] - Mawad R / 2009 / Graft-versus-host disease presenting with pancytopenia after en bloc multiorgan transplantation: case report and literature review / Transplant Proc 41 : 4431 ~ 4433
2. [학술지(정기간행물)] - Taylor AL / 2004 / Monitoring systemic donor lymphocyte macrochimerism to aid the diagnosis of graft-versus-host disease after liver transplantation / Transplantation 77 : 441 ~ 446
3. [학술지(정기간행물)] - Cho EH / 2007 / Acute graft versus host disease following living donor liver transplantation: first Korean report / Hepatogastroenterology 54 : 2120 ~ 2122
4. [학술지(정기간행물)] - Whalen JG / 2005 / Rash and pancytopenia as initial manifestations of acute graft-versus-host disease after liver transplantation / J Am Acad Dermatol 52 : 908 ~ 912
5. [학술지(정기간행물)] - Taylor AL / 2004 / Acute graft versus host disease following liver transplantation: the enemy within / Am J Transplant 4 : 466 ~ 474
2. [학술지(정기간행물)] - Taylor AL / 2004 / Monitoring systemic donor lymphocyte macrochimerism to aid the diagnosis of graft-versus-host disease after liver transplantation / Transplantation 77 : 441 ~ 446
3. [학술지(정기간행물)] - Cho EH / 2007 / Acute graft versus host disease following living donor liver transplantation: first Korean report / Hepatogastroenterology 54 : 2120 ~ 2122
4. [학술지(정기간행물)] - Whalen JG / 2005 / Rash and pancytopenia as initial manifestations of acute graft-versus-host disease after liver transplantation / J Am Acad Dermatol 52 : 908 ~ 912
5. [학술지(정기간행물)] - Taylor AL / 2004 / Acute graft versus host disease following liver transplantation: the enemy within / Am J Transplant 4 : 466 ~ 474
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UCI(KEPA) : I410-ECN-0101-2014-514-001267709