Fluorescence in situ hybridization-based confirmation of acute graftvs-host disease diagnosis following liver transplantation:A case report  

作　　者：Jing-Jing Xiao Jin-Yu Ma Jun Liao Di Wu Chao Lv Hai-Yang Li Shi Zuo Hai-Tao Zhu Hua-Jian Gu 

机构地区：[1]School of Clinical Medicine,Guizhou Medical University,Guiyang 550004,Guizhou Province,China [2]Department of Hepatobiliary Surgery,The Affiliated Hospital of Guizhou Medical University,Guiyang 550004,Guizhou Province,China [3]Department of Pediatric Surgery,The Affiliated Hospital of Guizhou Medical University,Guiyang 550004,Guizhou Province,China

出　　处：《World Journal of Gastrointestinal Surgery》2021年第9期1102-1109,共8页世界胃肠外科杂志（英文版）（电子版）

摘　　要：BACKGROUND Although acute graft-vs-host disease(aGvHD)is a rare complication of liver transplantation,it is poorly understood and has an extremely high mortality rate.No standardized diagnostic criteria or treatment regimens currently exist.CASE SUMMARY The present study investigated the etiology,diagnosis,and treatment of aGvHD following liver transplantation.Presentation,diagnosis,disease course,histology,and treatment of an aGvHD case are reported,and associated literature is reviewed.A 64-year-old female required LTx due to primary biliary cirrhosis.The donor was a 12-year-old male.Three weeks following liver transplantation,the recipient developed pyrexia,diarrhea,rashes,and antibiotic-unresponsive pancytopenia.Clinical symptoms together with laboratory investigations suggested a diagnosis of aGvHD,which was confirmed via peripheral blood fluorescent in situ hybridization.Donor XY chromosome fluorescent in situ hybridization indicating early chimerism achieved 93%sensitivity in the detection of GvHD.Existing immunosuppressants were discontinued,and high-dose intravenous methylprednisolone was initiated along with antibiotics.While diarrhea resolved,the patient’s general condition continued to deteriorate until demise due to multi-system organ failure at 37 d post-liver transplantation.This case illustrates the life-threatening nature of aGvHD.CONCLUSION Herein,we have summarized a post-LTx aGvHD case and reviewed associated literature in order to increase awareness and provide potentially risk-mitigating recommendations.

关 键 词：Liver transplantation Graft-vs-host disease Fluorescence in situ hybridization cytogenetics CHIMERISM Diagnosis Case report 

分 类 号：R657.3[医药卫生—外科学]