We describe the first case of a man who developed acute graft-versus-host disease (GVHD), isolated to the lung, after an orthotopic liver transplant from a female donor. Our patient experienced dyspnea, worsening hypoxemia, and a progressive obstructive ventilatory defect 12 days after liver transplantation. Open-lung biopsy revealed grade 2 lymphocytic bronchiolitis, the pathologic and immunologic correlate of acute pulmonary GVHD. Fluorescent in situ hybridization confirmed donor cells at sites of peribronchiolar inflammation. High-dose corticosteroids were given with a return to baseline pulmonary function. The current case should alert clinicians to investigate pulmonary GVHD as a potential cause of postoperative dyspnea in liver transplant recipients.;
|Pages (from-to)||968 - 971|
|Publication status||Published - 2002|
- Graft vs Host Disease/*etiology, Liver Transplantation/*adverse effects, Lung Diseases/*etiology, Acute Disease, Administration, Oral, Aged, Bronchitis/etiology, Bronchitis/pathology, Drug Administration Schedule, Female, Glucocorticoids/administration & dosage, Glucocorticoids/therapeutic use, Graft vs Host Disease/complications, Graft vs Host Disease/drug therapy, Humans, Injections, Intravenous, Lung Diseases/complications, Lung Diseases/drug therapy, Lymphocytes/pathology, Male, Methylprednisolone/administration & dosage, Methylprednisolone/therapeutic use, Prednisone/administration & dosage, Prednisone/therapeutic use, Treatment Outcome
Knox, K. S., Behnia, M., Smith, L. R., Vance, G. H., Busk, M., Cummings, O. W., ... Wilkes, D. S. (2002). Acute graft-versus-host disease of the lung after liver transplantation. Liver Transplantation, 8(10), 968 - 971.