Kim Jong Man, Kim Sung Joo, Joh Jae-Won, Kwon Choon Hyuck David, Jang Kee-Taek, An Jungsuk, Ki Chang-Seok, Kang Eun-Suk, Shin Milljae, Kim Bok Nyeo, Lee Suk-Koo
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
J Korean Surg Soc. 2011 Jun;80 Suppl 1(Suppl 1):S36-9. doi: 10.4174/jkss.2011.80.Suppl1.S36. Epub 2011 Jun 17.
Graft-versus-host disease (GVHD) is a rare complication after kidney transplantation. We describe a 62-year-old female with end-stage renal disease due to hypertension. She received a kidney with 4 mismatched human leukocyte antigen (HLA) out of 6 HLA - A, B, DR from a deceased donor. After the procedure, the patient showed watery diarrhea on postoperative day (POD) 45. An endoscopic biopsy of the colon revealed some apoptotic cells consistent with GVHD. Thrombocytopenia was gradually developed on POD 54. She received steroid pulse therapy, and thrombocytopenia did not progress. However, pneumonia, renal failure, and cardiac failure occurred. She died due to multiple organ failure. We must consider GVHD in renal transplant recipients without homozygous or identical HLA, who had only watery diarrhea without other typical GVHD symptoms such as skin rash and fever, although GVHD is rare in renal transplant recipients.
移植物抗宿主病（GVHD）是肾移植后一种罕见的并发症。我们描述了一名62岁因高血压导致终末期肾病的女性。她从一名已故供体处接受了一个肾脏，在6个HLA - A、B、DR中，有4个人类白细胞抗原（HLA）不匹配。术后，患者在术后第45天出现水样腹泻。结肠内镜活检显示一些与GVHD一致的凋亡细胞。术后第54天逐渐出现血小板减少。她接受了类固醇冲击治疗，血小板减少没有进展。然而，出现了肺炎、肾衰竭和心力衰竭。她因多器官衰竭死亡。尽管GVHD在肾移植受者中很少见，但对于没有纯合或相同HLA且仅有水样腹泻而无皮疹和发热等其他典型GVHD症状的肾移植受者，我们必须考虑到GVHD。
