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Graft Vs. Host Disease After Liver Transplant

Graft versus host disease (GVHD) is a rare complication of liver transplant, affecting less than 1 percent of liver recipients. GVHD can be acute, occurring in the first 3 months after transplant, or chronic, occurring after 3 months.

  1. Definition

    • GVHD is an attack by transplanted lymphocytes (white blood cells) in the liver on the host cells, with the host cells unable to fight off the attack.

    Causes

    • Transplant of a liver with HLA (human leukocyte antigen) antigens similar to those of the recipient initiates GVHD. For this reason, the disease is more common in living donor transplants between close relatives, according to a 2007 Journal of Burns and Wounds article.

    Symptoms

    • Symptoms of GVHD in the liver include fever, diarrhea, a red rash, possibly with large blisters (bullae), and a decreasing white blood count.

    Treatment

    • Increasing immune-suppression to destroy the donor cells and decreasing immune-suppression to allow the recipient's immune system to attack the donor cells have both been tried, according to a 2008 article reported in World Journal of Gastroenterology by Zhi-Yong Guo. New therapies need to be developed.

    Prognosis

    • Survival rates from GVHD are as low as 20 percent, according to Schulz. Death occurs from overwhelming sepsis due to the destruction of white blood cells by the graft.

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