Fatal graft-versus-host disease after living-donor liver transplantation from an HLA-DR-mismatched donor.
Pediatr Transplant
; 21(7)2017 Nov.
Article
em En
| MEDLINE
| ID: mdl-28834141
ABSTRACT
Acute GVHD is a rare complication after liver transplantation that has a high mortality rate. We experienced an infant case complicated with acute GVHD. An 8-month-old infant with biliary atresia underwent LDLT with a graft obtained from his mother. Their HLAs showed a donor-dominant one-way match, not at HLA-DR but at HLA-A, HLA-B, and HLA-C (recipient; A 31/33, B 51/54, C 1/14, DR 9/11, donor; A 31/-, B 51/-, C 14/-, DR 8/11). The patient exhibited a high fever, skin rash, and diarrhea, and was diagnosed with acute GVHD based on the blood chimerism test. Despite immunosuppression treatment with prednisolone and tacrolimus, plasma exchange, blood transfusion including cord blood transplantation, and antibiotics, the child died on postoperative day 126. Donor-dominant one-way matching at HLA class 1 can be a high-risk factor for acute GVHD despite HLA class 2 mismatching.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Antígenos HLA-DR
/
Transplante de Fígado
/
Doadores Vivos
/
Doença Enxerto-Hospedeiro
/
Histocompatibilidade
Tipo de estudo:
Risk_factors_studies
Limite:
Humans
/
Infant
/
Male
Idioma:
En
Revista:
Pediatr Transplant
Assunto da revista:
PEDIATRIA
/
TRANSPLANTE
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
Japão