From the Department of Pathology, Virginia Commonwealth University, Richmond, Virginia, USA.
Exp Clin Transplant. 2022 Nov;20(11):1031-1034. doi: 10.6002/ect.2021.0460. Epub 2022 Mar 15.
Graft-versus-host disease is an uncommon complication of solid-organ transplant and is associated with a high rate of mortality. Here, we describe a female patient with primary biliary cholangitis who developed graft-versus-host disease following an orthotopic liver and renal allotransplant from a deceased male donor. Systemic donor lymphoid chimerism is one of several important findings to confirm a diagnosis of graft-versus-host disease after solid-organ transplant, along with clinical and histologic findings. In this case, cytogenetic analyses and chimerism studies performed on blood, blood components, and bone marrow specimens obtained at several timepoints supported the diagnosis of graft-versus-host disease and demonstrated sustained near-complete donor engraftment of the lymphoid compartment. This case report illustrates the utility of chimerism testing to rapidly diagnose this serious condition in patients who have received a solid-organ transplant.
移植物抗宿主病是实体器官移植的一种罕见并发症，与高死亡率相关。在这里，我们描述了一位原发性胆汁性胆管炎女性患者，她在接受一名已故男性供体的原位肝肾联合移植后发生了移植物抗宿主病。供体淋巴细胞嵌合体是在实体器官移植后确认移植物抗宿主病诊断的几个重要发现之一，此外还有临床和组织学发现。在本例中，对多次获得的血液、血液成分和骨髓标本进行的细胞遗传学分析和嵌合体研究支持移植物抗宿主病的诊断，并显示了淋巴样细胞区持续近乎完全的供者嵌合。本病例报告说明了嵌合体检测在诊断接受实体器官移植的患者发生这种严重疾病中的作用。
