Graft versus host disease as a complication after liver transplantation: A rare but serious association

Pérez-Saborido, B.; Asensio-Díaz, E.; Barrera-Rebollo, A.; Rodríguez-López, M.; Gonzalo-Martín, Marta; Madrigal-Rubiales, Beatriz; García-Pajares, Félix; Pacheco-Sánchez, D.

doi:10.17235/reed.2015.3722/2015

Cited by 4 publications

(4 citation statements)

References 13 publications

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“…In contrast, the therapy of patients with increased immunosuppressive regimen included various drugs, immune globulin, and antibodies. These comprised the administration of antilymphocyte globulin, 42 anti–T-lymphocyte globulin, 11 – 13 , 15 , 19 , 21 , 22 , 25 , 27 , 28 , 30 , 32 , 37 , 43 , 49 , 53 – 55 , 58 , 64 , 74 , 75 , 78 , 82 , 83 , 86 , 88 , 90 , 91 , 94 , 98 , 102 , 110 , 111 , 117 – 119 , 126 , 129 , 132 intravenous immune globulin, 11 , 18 , 29 , 35 , 43 , 98 , 115 , 122 , 123 , 127 alemtuzumab, 91 , 99 , 100 , 111 , 124 basiliximab, 3 , 11 , 12 , 19 , 21 , 43 , 44 , 47 , 48 , 71 , 99 , 126 , 132 dacalizumab,...…”

Section: Resultsmentioning

confidence: 99%

“…Few data refer to the therapeutic regime of GvHD following SOT in the current literature. Furthermore, the majority of cases have been published as case reports; 2 – 4 , 16 – 18 , 22 , 25 , 28 , 30 , 31 , 34 – 38 , 42 – 46 , 48 – 54 , 56 , 58 , 60 , 61 , 65 , 67 , 69 – 77 , 80 – 90 , 92 , 95 – 103 , 105 – 109 , 111 – 120 , 122 – 128 , 130 , 132 – 134 , 138 – 141 thus, obtaining an overview of this sophisticated topic is aggravated. Treatment options for SOT-GvHD are also controversial as there is limited evidence given the scarcity and unaltered high mortality of cases, foreclosing a conclusive evidence-based therapy recommendation.…”

Section: Discussionmentioning

confidence: 99%

“…Increasing immunosuppressive therapy is frequently used in the therapy for GvHD following LT. 2 , 3 , 11 – 13 , 15 , 16 , 18 , 19 , 21 , 22 , 24 , 25 , 28 – 30 , 33 , 35 , 37 , 40 – 45 , 48 , 49 , 51 – 55 , 57 , 58 , 60 , 61 , 64 , 65 , 68 , 69 , 71 , 74 , 75 , 77 , 78 , 80 – 83 , 86 – 88 , 90 , 94 , 95 , 98 – 103 , 106 – 108 , 111 , 112 , 114 , 116 – 119 , 122 – 127 , 130 , 132 , 134 , 142 Undoubtedly, increased immunosuppression frequently leads to toxicity and infection, resulting in septic shock. 19 The treatment of GvHD with corticosteroids 4 , 11 , 13 , 19 , 21 , 33 , 36 , 38 , 39 ,…”

Section: Discussionmentioning

confidence: 99%

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Graft-versus-host disease following liver transplantation: A systematic review of literature

Kneifel,

Vogel,

Bormann

et al. 2023

Hepatology Communications

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Background: Graft-versus-host disease following liver transplantation is a serious and usually fatal complication. Data identifying the risk factors and specifying the diagnosis and treatment options of the disease are scarce and contentious. Moreover, recommendations for therapeutic approaches are similarly sparse. Methods: A systematic review of the literature from 1988 to 2020 on graft-versus-host disease following liver transplantation was performed using the PubMed and MEDLINE databases. Medical subject headings, such as graft-versus-host disease and GvHD were used in combination with solid organ transplant, transplantation, or liver transplant. Following duplicate removal, 9298 articles were screened for suitability. A total of 238 full-text articles were analyzed for eligibility, resulting in 130 eligible articles for meta-analysis. Two hundred twenty-five patients developing graft-versus-host disease following liver transplantation reported herein were mainly published in case reports and case series. Results: Graft-versus-host disease occurred with an incidence of 1.2%. 85% developed following deceased donor liver transplant and 15% following living-related donor liver transplantation. The median follow-up period following liver transplantation was 84 days (interquartile range, 45–180). The median time from liver transplantation to graft-versus-host disease onset was 30 days (interquartile range, 21–42). The main clinical features included skin rash (59%), fever (43%), diarrhea (36%), and pancytopenia (30%). The overall mortality rate was 71%. Neither univariate (HR = 0.999; 95% CI, 0.493–2.023; p = 1.0) nor multivariate Cox regression analysis revealed a significant correlation between adaptation of immunosuppression and survival probability (HR = 1.475; 95% CI, 0.659–3.303; p = 0.3). Conclusions: This systematic review suggests that an increase in immunosuppressive regimen does not yield any survival benefit in patients suffering from graft-versus-host disease following liver transplantation.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Graft-versus-host disease following liver transplantation: A systematic review of literature

Kneifel,

Vogel,

Bormann

et al. 2023

Hepatology Communications

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“…Duplicates excluded were the reports by Kuball et al (Schuchmann et al reported their patient ), by Sudhindran et al and Taylor et al (Key et al had described their patients ), and by Neumann et al (Kohler et al had previously published their patient ). A total of 78 studies were withheld, in which a total of 150 patients with LTx‐associated GVHD were identified …”

Section: Methodsmentioning

confidence: 99%

Improved survival after LTx-associated acute GVHD with mAb therapy targeting IL2RAb and soluble TNFAb: Single-center experience and systematic review

Minnee

Fieuws

Jochmans

et al. 2018

American Journal of Transplantation

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Acute graft-versus-host disease (GVHD) after liver transplant (LTx) is a rare complication with a high mortality rate. Recently, monoclonal antibody (mAb) treatment, specifically with anti-interleukin 2 receptor antibodies (IL2RAb) and anti-tumor necrosis factor-α antibodies (TNFAb), has gained increasing interest. However, evidence is mostly limited to case reports and the efficacy remains unclear. Here, we describe 5 patients with LTx-associated GVHD from our center and provide the results of our systematic literature review to evaluate the potential therapeutic benefit of IL2RAb/TNFAb treatment. Of the combined population of 155 patients (5 in our center and 150 through systematic search), 24 were given mAb (15.5%)-4 with TNFAb (2.6%) and 17 with IL2RAb (11%) ("mAb group")-and compared with patients who received other treatments (referred to as "no-mAb group"). Two-sided Fisher exact tests revealed a better survival when comparing treatment with mAb versus no-mAb (11/24 vs 27/131; P = .018), TNFAb versus no-mAb (3/4 vs 27/131; P = .034), and IL2RAb versus no-mAb (8/17 vs 27/131; P = .029). This systematic review suggests a beneficial effect of mAb treatment and a promising role for TNFAb and IL2RAb as a first-line strategy to treat LTx-associated acute GVHD.

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Dermatologic manifestations of solid organ transplantation–associated graft-versus-host disease: A systematic review

Kim

Schmelkin

Davis

et al. 2018

Journal of the American Academy of Dermatology

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Graft versus host disease as a complication after liver transplantation: A rare but serious association

Cited by 4 publications

References 13 publications

Graft-versus-host disease following liver transplantation: A systematic review of literature

Graft-versus-host disease following liver transplantation: A systematic review of literature

Improved survival after LTx-associated acute GVHD with mAb therapy targeting IL2RAb and soluble TNFAb: Single-center experience and systematic review

Dermatologic manifestations of solid organ transplantation–associated graft-versus-host disease: A systematic review

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