Solid Organ Transplant Graft-Versus-Host Disease in a Kidney/Pancreas Transplant Patient: Use of Chimerism Testing and a Rare Presentation of Cutaneous GVHD

Amrita Goyal, Jeremy Allred, Raja Kandaswamy, Erik B Finger, Daniel O Keys, Samy Riad, Alessio Giubellino, Daniel D Miller, Christine G Lian, Shernan G Holtan

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction. Solid organ transplant graft-versus-host disease (SOT-GVHD) is a rare phenomenon in which recipients of solid organ transplant develop GVHD due to the presence of donor lymphocytes in the graft. SOT-GVHD most often occurs in patients receiving small bowel or liver transplants. Diagnosis is typically via identification of lymphocytic infiltration on histopathology and molecular demonstration of donor T cell chimerism in the target organ. The gastrointestinal (GI) system is the most common target of SOT-GVHD, and one estimate places long-term survival of patients with SOT-GVHD at 20% at 5 years. In this report, we present the case of a patient with sequential kidney and pancreas transplant who developed SOT-GVHD targeting host lymphocytes, skin, and liver, with a long period of stability before treatment with antithymocyte globulin. Peripheral blood chimerism testing was used to track response to therapy. Remarkably, he survived 1.5 years despite recurrent infections before dying of unrelated causes.

Original languageEnglish (US)
Pages (from-to)6539808
JournalCase reports in transplantation
Volume2022
DOIs
StatePublished - 2022

Bibliographical note

Copyright © 2022 Amrita Goyal et al.

PubMed: MeSH publication types

  • Case Reports

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