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GRAFT-VERSUS-HOST DISEASE IN PEDIATRIC LIVING DONOR LIVER TRANSPLANT

JOSEPH J VALAMPARAMPİL, G VİMAL KUMAR, NARESH SHANMUGAM, MUKUL VİJ, DEENADAYALAN MUNİRATHNAM, ASHWİN RAMMOHAN, MOHAMED RELA

Experimental and Clinical Transplantation - 2022;20(12):1137-1140

Institute of Liver Disease and Transplantation and the Department of Paediatric Haematology, Oncology and Bone Marrow Transplantation, Dr. Rela Institute and Medical Centre, Bharath Institute of Higher Education and Research, Chennai, India

 

Acute graft-versus-host disease is an extremely rare complication after pediatric liver transplant. Despite a better prognosis in pediatric than in adult recipients, graft-versus-host disease is associated with high mortality. We report 2 cases of pediatric recipients with acute graft-versus-host disease; both had identical clinical presentation. Remission was achieved in both patients, but the first patient developed Epstein-Barr virus-induced posttransplant lymphoproliferative disease and recurrence of graft-versus-host disease after the immunosuppression regimen was altered. The treatment options and clinical considerations for care of such patients are discussed. It is important to maintain a high degree of suspicion for graft-versushost disease in every posttransplant patient with persistent skin rash, with or without fever and diarrhea, and confirm the diagnosis.