PMID- 27555077
OWN - NLM
STAT- MEDLINE
DCOM- 20180723
LR  - 20181202
IS  - 1526-9248 (Print)
IS  - 1526-9248 (Linking)
VI  - 26
IP  - 4
DP  - 2016 Dec
TI  - Fatal Graft-Versus-Host Disease Following Adult-To-Adult Living Donor Liver 
      Transplantation From an HLA Nonhomozygous Donor.
PG  - 394-396
LID - 10.1177/1526924816664087 [doi]
AB  - The use of a human leukocyte antigen (HLA) homozygous donor to a haploidentical 
      recipient is a well-documented cause of transfusion-associated graft-versus-host 
      disease (GVHD). Several authors have reported that use of a graft from an 
      HLA-homozygous donor with 1-way donor-recipient HLA matching led to an extremely 
      high risk of developing GVHD in LDLT. We have experienced a fatal case of acute 
      GVHD following adult-to-adult LDLT from a donor who was heterozygous at a single 
      HLA locus. A 53-year-old female underwent LDLT for chronic hepatitis B and 
      recurrent hepatocellular carcinoma. The donor was her 23-year-old son. The HLA 
      phenotype of the donor was not homozygous (A24, -; B54, -; DR4, 9) and revealed 
      one-way donor-dominant HLA matching at two loci with the recipient (A2, 24; B48, 
      54; DR4, 12). On the fortieth postoperative day, the patient showed erythematous 
      skin lesions. Skin biopsy revealed typical findings of GVHD. Donor-derived 
      chimerism was demonstrated by performing fluorescent in situ hybridization (FISH) 
      using the recipient's skin tissue. As the clinical course deteriorated, 
      etanercept was started in addition to broad-spectrum antibiotics but there was no 
      improvement. As multi-organ failure progressed, the patient succumbed to death on 
      the 54th postoperative day, which was 2 weeks after onset of GVHD. The prevention 
      of GVHD is more important since the results of treatment have been disappointing. 
      We have experienced a fatal case of acute GVHD following adult-to-adult LDLT from 
      a HLA non-homozygous donor. HLA heterozygosity at a single locus does not 
      preclude the possibility of developing GVHD following adult-to-adult LDLT.
FAU - Yu, Young-Dong
AU  - Yu YD
AD  - 1 Division of HBP surgery and Liver transplantation, Department of Surgery, Korea 
      University Medical Center, Korea University Medical College, Seoul, Korea.
FAU - Kim, Dong-Sik
AU  - Kim DS
AD  - 1 Division of HBP surgery and Liver transplantation, Department of Surgery, Korea 
      University Medical Center, Korea University Medical College, Seoul, Korea.
FAU - Ha, Neul
AU  - Ha N
AD  - 1 Division of HBP surgery and Liver transplantation, Department of Surgery, Korea 
      University Medical Center, Korea University Medical College, Seoul, Korea.
FAU - Jung, Sung-Won
AU  - Jung SW
AD  - 1 Division of HBP surgery and Liver transplantation, Department of Surgery, Korea 
      University Medical Center, Korea University Medical College, Seoul, Korea.
FAU - Han, Jae-Hyun
AU  - Han JH
AD  - 1 Division of HBP surgery and Liver transplantation, Department of Surgery, Korea 
      University Medical Center, Korea University Medical College, Seoul, Korea.
FAU - Kim, Joo-Young
AU  - Kim JY
AD  - 2 Department of Pathology, Korea University Medical Center, Seoul, Korea.
FAU - Park, Sung-Hwan
AU  - Park SH
AD  - 3 Department of Forensic Medicine, Korea University Medical Center, Seoul, Korea.
FAU - Cho, Yun-Jung
AU  - Cho YJ
AD  - 4 Department of Laboratory Medicine, Korea University Medical Center, Seoul, 
      Korea.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20160920
PL  - United States
TA  - Prog Transplant
JT  - Progress in transplantation (Aliso Viejo, Calif.)
JID - 100909380
RN  - 0 (HLA Antigens)
MH  - Adult
MH  - Fatal Outcome
MH  - Female
MH  - *Graft vs Host Disease
MH  - *HLA Antigens
MH  - Histocompatibility Testing
MH  - Humans
MH  - In Situ Hybridization, Fluorescence
MH  - Liver Neoplasms/surgery
MH  - *Liver Transplantation
MH  - *Living Donors
MH  - Middle Aged
OTO - NOTNLM
OT  - graft-versus-host disease
OT  - human leukocyte antigen
OT  - living donor liver transplantation
OT  - nonhomozygous
OT  - related body regions
OT  - transplant donor
EDAT- 2016/08/25 06:00
MHDA- 2016/08/25 06:01
CRDT- 2016/08/25 06:00
PHST- 2016/08/25 06:00 [pubmed]
PHST- 2016/08/25 06:01 [medline]
PHST- 2016/08/25 06:00 [entrez]
AID - 1526924816664087 [pii]
AID - 10.1177/1526924816664087 [doi]
PST - ppublish
SO  - Prog Transplant. 2016 Dec;26(4):394-396. doi: 10.1177/1526924816664087. Epub 2016 
      Sep 20.