PMID- 15307833
OWN - NLM
STAT- MEDLINE
DCOM- 20050208
LR  - 20230124
IS  - 1600-6135 (Print)
IS  - 1600-6135 (Linking)
VI  - 4
IP  - 9
DP  - 2004 Sep
TI  - Graft versus host disease in intestinal transplantation.
PG  - 1459-65
AB  - Our aim was to analyze the clinical course and outcome of patients with graft vs. 
      host disease (GVHD) after intestinal transplantation (ITx). All patients 
      receiving ITx between May, 1990 and December, 2003 were retrospectively reviewed 
      for evidence of GVHD. Two hundred and fifty patients underwent ITx during the 
      study period. Graft vs. host disease was suspected clinically in 23 patients on 
      the clinical basis of presentation such as skin rash, ulceration of oral mucosa, 
      diarrhea, lymphadenopathy, or native liver dysfunction. Fourteen (eight children 
      and six adults) patients (5.6% of total patient population) had GVHD confirmed by 
      histopathological criteria including keratinocyte necrosis (n = 9), epithelial 
      apoptosis of the native gastrointestinal tract (n = 4), and epithelial cell 
      necrosis of oral mucosa (n = 1). Donor-cell tissue infiltration or extensive 
      peripheral blood donor-cell chimerism was documented on seven occasions. The 
      majority of cases of GVHD resolved with steroid administration and optimization 
      of tacrolimus immunosuppression. The incidence of histologically proven GVHD 
      after clinical intestinal transplantation is 6.5% (8/122) in children and 4.7% 
      (6/128) in adults. Successful clinical management requires a high index of 
      suspicion to minimize morbidity and mortality. Diagnostic and treatment 
      strategies based on this experience are proposed.
CI  - Copyright 2004 Blackwell Munksgaard
FAU - Mazariegos, George V
AU  - Mazariegos GV
AD  - Children's Hospital of Pittsburgh, Thomas E. Starzl Transplantation Institute, 
      University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. 
      mazarieg@pitt.edu
FAU - Abu-Elmagd, Kareem
AU  - Abu-Elmagd K
FAU - Jaffe, Ronald
AU  - Jaffe R
FAU - Bond, Geoffrey
AU  - Bond G
FAU - Sindhi, Rakesh
AU  - Sindhi R
FAU - Martin, Lillian
AU  - Martin L
FAU - Macedo, Camila
AU  - Macedo C
FAU - Peters, John
AU  - Peters J
FAU - Girnita, Alin
AU  - Girnita A
FAU - Reyes, Jorge
AU  - Reyes J
LA  - eng
GR  - DK29961/DK/NIDDK NIH HHS/United States
PT  - Journal Article
PT  - Research Support, U.S. Gov't, Non-P.H.S.
PT  - Research Support, U.S. Gov't, P.H.S.
PL  - United States
TA  - Am J Transplant
JT  - American journal of transplantation : official journal of the American Society of 
      Transplantation and the American Society of Transplant Surgeons
JID - 100968638
RN  - 0 (Immunosuppressive Agents)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Child
MH  - Child, Preschool
MH  - Drug Therapy, Combination
MH  - Female
MH  - Graft vs Host Disease/*immunology/pathology
MH  - Humans
MH  - Immunosuppressive Agents/therapeutic use
MH  - Infant
MH  - Intestines/*transplantation
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Transplantation, Homologous/immunology/pathology
EDAT- 2004/08/17 10:00
MHDA- 2005/02/09 09:00
CRDT- 2004/08/17 10:00
PHST- 2004/08/17 10:00 [pubmed]
PHST- 2005/02/09 09:00 [medline]
PHST- 2004/08/17 10:00 [entrez]
AID - S1600-6135(22)07958-8 [pii]
AID - 10.1111/j.1600-6143.2004.00524.x [doi]
PST - ppublish
SO  - Am J Transplant. 2004 Sep;4(9):1459-65. doi: 10.1111/j.1600-6143.2004.00524.x.