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Clinical analysis of 3 cases of graft versus host disease after liver transplantation

Cao Junning;Teng Dahong;Xu Chuanshen;Dai Deshu;Sun Yandong;Wang Feng;Xu Qingguo;Cai Jinzhen;Organ Transplant Center, The Affiliated Hospital of Qingdao University;  
Objective To investigate the diagnosis and treatment of graft-versus-host-disease(GVHD) after liver transplantation. Methods The data of patients with GVHD after liver transplantation in The Affiliated Hospital of Qingdao University from January 2020 to April 2022 were collected, and their clinical characteristics and treatment experience were descriptively analyzed. Results Three patients developed GVHD after liver transplantation, all died due to sepsis and multiple organ failure. Typical clinical symptoms include fever, rash, diarrhea, and myelosuppression. Skin pathological biopsy showed epidermal keratosis, vacuolar degeneration of basal layer cells and lymphocyte infiltration in dermis. Chimerism rate of T lymphocytes showed donor T lymphocyte chimerism. Treatment strategies included infection prevention, withdrawal of immunosuppressive agents, high-dose glucocorticoid bolus therapy, monoclonal antibody therapy and symptomatic support therapy. Conclusion The prognosis of GVHD after liver transplantation is poor. The diagnosis of GVHD after liver transplantation is based on typical clinical symptoms and auxiliary examinations, and the comprehensive treatment strategy is based on highdose glucocorticoid bolus therapy.
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