Journal of Liver: Disease & TransplantationISSN: 2325-9612

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Case Report, J Liver Disease Transplant Vol: 5 Issue: 3

High-Resolution (HR) HLATyping Can Confirm the Diagnosis of Graft Versus Host Disease (GVHD)After Orthotopic Liver-Transplantation (OLT)

Soumya Pandey1*, Bobbie Rhodes-Clark1, Daniel Borja-Cacho2, Yogesh Jethava3 and Terry O Harville1
1Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
2Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
3Department of Internal Medicine, Division of Hematology-Oncology, University of Arkansas for Medical Sciences, Little Rock, USA
Corresponding author : Soumya Pandey
Department of Pathology, University of Arkansas for Medical Sciences, 4301 W Markham Street, Little Rock, 72205, USA
Tel: (501) 686-5491
Fax: (501) 686-7151
E-mail: [email protected]
Received: December 03, 2016 Accepted: December 28, 2016 Published: December 31, 2016
Citation: Pandey S, Rhodes-Clark B, Borja-Cacho D, Jethava Y, Harville TO (2016) High-Resolution (HR) HLA-Typing Can Confirm the Diagnosis of Graft Versus Host Disease (GVHD) After Orthotopic Liver-Transplantation (OLT). J Liver Disease Transplant 5:3 doi: 10.4172/2325-9612.1000143

Abstract

Acute graft versus host disease (GVHD) following orthotopic liver transplantation (OLT) is a rare but severe disease. GVHD diagnosis can often be delayed, since the symptoms are non-specific. We present a case of a 62 year-old male with end-stage liver disease who underwent OLT. There were no major peri-transplant complications. Patient presented ~4 weeks post-OLT, with fever,cough, throat discomfort, and rash; and was treated for suspected infection with broad-spectrum antimicrobials. ~5 weeks post-OLT, patient became pancytopenic, and a skin biopsy was suspicious for GVHD. Bone marrow biopsy was performed and revealed extreme pancytopenia with necrosis. The individual pre-OLT patient and donor types were compared at the serologic equivalent and high-resolution (HR) HLA-type, without clear indication of risk for GVHD, and or graft rejection. HR HLA-typing was performed on bone marrow cells obtained post-OLT and compared with the pre-OLT specimen to demonstrate donor lymphoid chimerism. HR typing results from the patient’s bone marrow post-OLT indicated the presence of all four alleles, and along with the clinical features,confirmed the diagnosis of GVHD. This case demonstrates howHR HLA typing can aid in rapid diagnosis and early recognition of GVHD post-OLT.

Keywords: HR-HLA typing; GVHD; OLT

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