A case of chronic graft-versus-host disease following living-related donor kidney transplantation.

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.