Immunological basis for treatment of graft versus host disease after liver transplant. (3rd May 2016)

• Record Type: Journal Article
• Authors: Rai, Vikrant; Dietz, Nicholas Edward; Agrawal, Devendra K.
• Is Part Of: Expert review of clinical immunology. Volume 12:Number 5(2016)
• Page Start: 583
• Page End: 593
• Publication Date: 2016-05-03
• Subjects: Graft versus host disease -- liver transplant -- Immunoreactivity -- T lymphocytes -- Surface antigens -- Chimerism -- Opportunistic infections -- Sepsis -- Multi organ failure; Clinical immunology -- Periodicals; 616.079
• DOI: 10.1586/1744666X.2016.1145056
• Languages: English
• ISSNs: 1744-666X

Abstract

ABSTRACT: Graft versus host disease (GVHD) after liver transplant, although a rare disease, has a very high mortality rate. GVHD occurs due to immunoreactions caused by donor T lymphocytes and host cell surface antigens resulting in proliferation and clonal expansion of T lymphocyte. Migration of effector cells, including macrophages, NK cells and cytotoxic T lymphocyte, to the target organs such as skin, intestine and bone marrow results in skin rashes, diarrhea and bone marrow depression. GVHD is diagnosed by clinical symptoms, histopathological findings and by the presence of chimerism. The delayed diagnosis, opportunistic infections and lack of definitive treatment of post orthotopic liver transplant (OLT)-GVHD results in sepsis and multi-organ failure leading to very low survival rates. In this review, we have focused on early diagnosis and critically discuss novel treatment modalities to decrease the incidence of GVHD.