Ohtsuka Y, Sakemi T, Ichigi Y, Tanaka T, Nakamura K
Division of Nephrology, Saga Medical School, Nabeshima, Japan.
Nephron. 1998;78(2):215-7. doi: 10.1159/000044914.
A 25-year-old man with a 2.5-year history of maintenance hemodialysis underwent a living-related donor (father) kidney transplantation. He was free from acute rejection, but 8 months after the kidney transplantation, he complained of malaise and fever which were accompanied by eruptions on the face, fingers, and hips which resembled symptoms seen in patients suffering from systemic vasculitis. Skin biopsy findings were compatible with those of chronic graft-versus-host disease (GVHD). The human leukocyte antigen (HLA) family study disclosed that the donor's HLA haplotype was homozygous and identical to one of the recipient's HLA haplotypes which indicated that the host would not resist engraftment. On the basis of these findings, a diagnosis of chronic GVHD was made, and increasing doses of immunosuppressants resulted in a resolution of these symptoms. Our report is the first describing GVHD that developed in a patient undergoing related-donor kidney transplantation.
一名接受维持性血液透析2.5年的25岁男性接受了亲属活体供肾（父亲）肾移植。他未发生急性排斥反应，但肾移植8个月后，他出现全身不适和发热，并伴有面部、手指和臀部皮疹，这些症状与系统性血管炎患者所见相似。皮肤活检结果与慢性移植物抗宿主病（GVHD）相符。人类白细胞抗原（HLA）家族研究显示，供体的HLA单倍型是纯合的，且与受体的一个HLA单倍型相同，这表明宿主不会抵抗植入。基于这些发现，诊断为慢性GVHD，增加免疫抑制剂剂量后这些症状得到缓解。我们的报告是首例描述亲属供肾肾移植患者发生GVHD的病例。
