Osband A J, Laskow D A, Mann R A
Kidney and Pancreas Transplant Center, Robert Wood Johnson Medical School, 10 Plum St, 7th Floor, New Brunswick, NJ 08901, USA.
Transplant Proc. 2010 Nov;42(9):3894-7. doi: 10.1016/j.transproceed.2010.08.058.
Whereas neutropenia is common after solid-organ transplantation, graft-vs-host disease is unusual, especially after simultaneous pancreas-kidney transplantation. Most cases reported in the literature give few details of treatment approach, and all were fatal. A 45-year-old man with diabetes underwent simultaneous pancreas-kidney transplantation at our center, with organs from a female donor. Two weeks postoperatively, he was readmitted with fever, malaise, and neutropenia. A bone marrow biopsy specimen demonstrated that two-thirds of the lymphocytes were of female karyotype. Graft-vs-host disease was diagnosed. Aggressive immunosuppression therapy was administered; however, the patient died. To our knowledge, this is the first case report with specific details of a treatment protocol and sequential short tandem repeat data.
实体器官移植后中性粒细胞减少很常见，而移植物抗宿主病并不常见，尤其是在胰肾联合移植后。文献报道的大多数病例很少详细说明治疗方法，且均为致命病例。一名45岁的糖尿病男性在我们中心接受了胰肾联合移植，供体为一名女性。术后两周，他因发热、不适和中性粒细胞减少再次入院。骨髓活检标本显示三分之二的淋巴细胞为女性核型。诊断为移植物抗宿主病。给予了积极的免疫抑制治疗；然而，患者死亡。据我们所知，这是第一例有治疗方案具体细节和序列短串联重复数据的病例报告。
