Immunological basis for treatment of graft versus host disease after liver transplant

Vikrant Rai, Nicholas Edward Dietz, Devendra K. Agrawal

Research output: Contribution to journalReview article

2 Scopus citations

Abstract

Graft versus host disease (GVHD) after liver transplant, although a rare disease, has a very high mortality rate. GVHD occurs due to immunoreactions caused by donor T lymphocytes and host cell surface antigens resulting in proliferation and clonal expansion of T lymphocyte. Migration of effector cells, including macrophages, NK cells and cytotoxic T lymphocyte, to the target organs such as skin, intestine and bone marrow results in skin rashes, diarrhea and bone marrow depression. GVHD is diagnosed by clinical symptoms, histopathological findings and by the presence of chimerism. The delayed diagnosis, opportunistic infections and lack of definitive treatment of post orthotopic liver transplant (OLT)-GVHD results in sepsis and multi-organ failure leading to very low survival rates. In this review, we have focused on early diagnosis and critically discuss novel treatment modalities to decrease the incidence of GVHD.

Original languageEnglish
Pages (from-to)583-593
Number of pages11
JournalExpert Review of Clinical Immunology
Volume12
Issue number5
DOIs
StatePublished - May 3 2016

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy
  • Immunology

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