Preliminary experiences on the treatment graft versus host disease after liver transplantation
- VernacularTitle:肝移植术后移植物抗宿主病治疗的初步经验(附2例报道)
- Author:
Guosheng DU
;
Bingyi SHI
;
Zhidong ZHU
- Publication Type:Journal Article
- Keywords:
liver transplantation;
graft versus host disease;
rejection
- From:
Medical Journal of Chinese People's Liberation Army
1982;0(01):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To summarize the clinical experiences of diagnosis and treatment of graft versus host disease (GVHD) in patients, who had undergone liver transplantation. Methods The clinical symptoms, diagnosis, treatment and clinical effect of 2 patients with GVHD were analyzed, including the time of occurrence of GVHD after operation, the sequence of clinical symptoms, the methods of administration and the dosage of immunosuppressant, as well as therapeutic measures when the disease was confirmed. Results Both patients developed unidentified high fever, skin rash and gastrointestinal syndromes on the 19th and 20th day, respectively, after orthotopic liver transplantation, and then pancytopenia occurred. There was no obvious signs of liver dysfunction during the period. One of the two patients died of mixed infection and multiple organ failure the 34th day after the transplantation with an increased dosage of glucocorticoid and immunosuppressant. The other patient was highly suspected of having GVHD at the early period and treated with small dose of methylprednisone and immunosuppressant, or completely withheld the immunosuppressant contingent on the condition of the patient. Gamma globulin was used for upholding the immunity, nasal feeding for energy supplementation, and antibiotics, fungicide and antivirotics were administered to the patient. This patient was cured and still alive and healthy. Conclusions Patients with unidentified high fever, skin rash and gastrointestinal symptoms after liver transplantation should be suspected to have GVHD. Decrease the dose or withhold immunosuppressant, symptomatic treatment, supplementation of nutrition, prevention of combined infections, and maintenance of immune function may be the optimal treatment of GVHD.
