Clinically evident, generalized graft-vs.-host disease is not thought to occur as a consequence of transplantation of most solid organs. The large inoculum of donor lymphoid cells required and the inability of the recipient to destroy these passenger cells are apparently rarely produced by solid-organ transplantation. However, there is a risk of graft-vs.-host disease when normal spleens are included in vascularized pancreas transplants.
We report on a case of severe, generalized acute graft-vs.-host disease in a recipient of a liver tranplant, involving documented transient chimerism of donor origin. This life-threatening complication was treated successfully with increase in the corticosteroid dosage and administration of anti-thymocyte globulin.