PMID- 17394149
OWN - NLM
STAT- MEDLINE
DCOM- 20070613
LR  - 20070416
IS  - 1527-6465 (Print)
IS  - 1527-6465 (Linking)
VI  - 13
IP  - 4
DP  - 2007 Apr
TI  - Recipient and donor factors influence the incidence of graft-vs.-host disease in 
      liver transplant patients.
PG  - 516-22
AB  - Acute cellular graft-vs.-host disease (GVHD) following liver transplantation has 
      an incidence of 1 to 2% and a mortality rate of 85%. Our aim was to identify a 
      patient population at high risk for developing GVHD using a large clinical 
      database to study both recipient and donor factors. We compared our liver 
      transplant patients who developed GVHD to those that did not for recipient and 
      donor factors and combinations of factors. For 2003-2004 we had 205 first-time 
      liver transplant patients surviving >30 days. From this group, 4 (1.9%) developed 
      GVHD. Compared to the control group, there were no significant differences in 
      recipient age, recipient gender, donor age, donor gender, total ischemia time, 
      donor-recipient human leukocyte antigen (HLA) mismatch, or donor-recipient age 
      difference. Percentages of liver disease etiologies among the patients who 
      developed GVHD were as follows: 16% (1/6) autoimmune hepatitis (AIH) (P = 0.003), 
      5.6% (3/54) alcoholic liver disease (ALD) (P = 0.057), and 7.1% (3/42) 
      hepatocellular carcinoma (HCC) (P = 0.026). The incidence of GVHD in patients 
      with glucose intolerance (either Type I or Type II diabetes mellitus [DM]) was 
      significant (P = 0.022). Focusing on patients only with high-risk factors for 
      GVHD during the years 2003-2005, we had 19 such patients. Four of these high-risk 
      patients developed GVHD. Three of these 4 patients had received a donor liver 
      with steatosis of degree >or=mild compared to only 2 of the 15 high-risk patients 
      who did not develop GVHD (P = 0.037). In conclusion, we have identified liver 
      transplant patients with AIH or the combination of ALD, HCC, and glucose 
      intolerance who receive a steatotic donor liver as being at high risk for 
      developing GVHD.
FAU - Chan, Edie Y
AU  - Chan EY
AD  - Division of Transplantation, Department of Surgery, University of Washington, 
      Seattle, WA 98195, USA.
FAU - Larson, Anne M
AU  - Larson AM
FAU - Gernsheimer, Terry B
AU  - Gernsheimer TB
FAU - Kowdley, Kris V
AU  - Kowdley KV
FAU - Carithers, Robert L Jr
AU  - Carithers RL Jr
FAU - Reyes, Jorge D
AU  - Reyes JD
FAU - Perkins, James D
AU  - Perkins JD
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Liver Transpl
JT  - Liver transplantation : official publication of the American Association for the 
      Study of Liver Diseases and the International Liver Transplantation Society
JID - 100909185
SB  - IM
MH  - Graft vs Host Disease/*epidemiology
MH  - Humans
MH  - Liver Transplantation/adverse effects/*statistics & numerical data
MH  - Risk Factors
MH  - Tissue Donors/*statistics & numerical data
RF  - 58
EDAT- 2007/03/31 09:00
MHDA- 2007/06/15 09:00
CRDT- 2007/03/31 09:00
PHST- 2007/03/31 09:00 [pubmed]
PHST- 2007/06/15 09:00 [medline]
PHST- 2007/03/31 09:00 [entrez]
AID - 10.1002/lt.21082 [doi]
PST - ppublish
SO  - Liver Transpl. 2007 Apr;13(4):516-22. doi: 10.1002/lt.21082.