Acute graft-versus-host disease of the lung after liver transplantation |
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| Affiliation: | 1. Department of Pediatrics University of Minnesota Medical School, Minneapolis, MN, USA;2. University of Minnesota Informatics Institute University of Minnesota, Minneapolis, MN, USA;3. Biostatistical Design and Analysis Center Clinical and Translational Science Institute University of Minnesota Medical School, Minneapolis, MN, USA;4. Department of Genetics, Cell Biology and Development University of Minnesota Medical School, Minneapolis, MN, USA;5. Comparative Pathology Shared Resource, Department of Veterinary Clinical Sciences, College of Veterinary Medicine, St. Paul, MN, USA;6. Department of Blood and Marrow Transplant University of Minnesota Medical School, Minneapolis, MN, USA;7. Gene Therapy Center Department of Pediatrics University of Minnesota Medical School Minneapolis, MN, USA;1. Manashi Chakrabarti Foundation, Kolkata, India;2. Department of Blood and Marrow Transplantation, Dharamshila Hospital and Research Centre, New Delhi, India;3. Fred Hutchinson Cancer Research Centre, Seattle, Washington, USA |
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| Abstract: | ![]()
We describe the first case of a man who developed acute graft-versus-host disease (GVHD), isolated to the lung, after an orthotopic liver transplant from a female donor. Our patient experienced dyspnea, worsening hypoxemia, and a progressive obstructive ventilatory defect 12 days after liver transplantation. Open-lung biopsy revealed grade 2 lymphocytic bronchiolitis, the pathologic and immunologic correlate of acute pulmonary GVHD. Fluorescent in situ hybridization confirmed donor cells at sites of peribronchiolar inflammation. High-dose corticosteroids were given with a return to baseline pulmonary function. The current case should alert clinicians to investigate pulmonary GVHD as a potential cause of postoperative dyspnea in liver transplant recipients. (Liver Transpl 2002;8:968-971.) |
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