Ito K, Fujita M, Norioka M, Yoshida H, Arii S, Tanaka J, Tobe T, Kakuyama M, Maruya E, Saji H
Department of Transfusion Medicine, Kyoto University, Japan.
Eur J Haematol. 1991 Apr;46(4):217-22. doi: 10.1111/j.1600-0609.1991.tb00544.x.
Fatal "postoperative erythroderma" (POE) developed in 2 patients treated with liver lobectomy and the transfusion of fresh blood. Their clinical features and skin-histological findings were indicative of acute graft-versus-host disease (GVHD). The HLA phenotypes of circulating lymphocytes of the 2 patients were heterozygous but became homozygous late in the clinical course and were identical with those of the blood donors. One of the patient's haplotypes was identical with the donor's homozygous haplotype. These findings suggest the mechanism of development of POE in apparently immunocompetent patients. The donor's T lymphocytes are histocompatible with the patient's tissues, are not rejected, and become engrafted. The patient's tissues are not histocompatible with the donor's, so that GVHD develops.
2例接受肝叶切除术并输注新鲜血液治疗的患者发生了致命的“术后红皮病”（POE）。他们的临床特征和皮肤组织学表现提示为急性移植物抗宿主病（GVHD）。这2例患者循环淋巴细胞的HLA表型为杂合型，但在病程后期变为纯合型，且与献血者的表型相同。其中1例患者的单倍型与献血者的纯合单倍型相同。这些发现提示了在明显免疫功能正常的患者中POE的发生机制。供体的T淋巴细胞与患者的组织具有组织相容性，未被排斥，并得以植入。而患者的组织与供体的组织不具有组织相容性，从而发生GVHD。
