Acute graft-versus-host disease of the lung after liver transplantation
Article first published online: 30 DEC 2003
Copyright © 2002 American Association for the Study of Liver Diseases
Volume 8, Issue 10, pages 968–971, October 2002
How to Cite
Knox, K. S., Behnia, M., Smith, L. R., Vance, G. H., Busk, M., Cummings, O. W., Kwo, P. Y. and Wilkes, D. S. (2002), Acute graft-versus-host disease of the lung after liver transplantation. Liver Transpl, 8: 968–971. doi: 10.1053/jlts.2002.35552
- Issue published online: 30 DEC 2003
- Article first published online: 30 DEC 2003
- National Institutes of Health. Grant Numbers: HL60797, HL03385, HL67177 to D.S.W.
- National Institutes of Health. Grant Number: HL04545 to K.S.K.
We describe the first case of a man who developed acute graft-versus-host disease (GVHD), isolated to the lung, after an orthotopic liver transplant from a female donor. Our patient experienced dyspnea, worsening hypoxemia, and a progressive obstructive ventilatory defect 12 days after liver transplantation. Open-lung biopsy revealed grade 2 lymphocytic bronchiolitis, the pathologic and immunologic correlate of acute pulmonary GVHD. Fluorescent in situ hybridization confirmed donor cells at sites of peribronchiolar inflammation. High-dose corticosteroids were given with a return to baseline pulmonary function. The current case should alert clinicians to investigate pulmonary GVHD as a potential cause of postoperative dyspnea in liver transplant recipients.