Acute graft-versus-host disease following simultaneous pancreas-kidney transplantation: report of a case

作者：Asari Sadaki^*; Matsumoto Ippei; Toyama Hirochika; Shinzeki Makoto; Goto Tadahiro; Tanaka Masaki; Shirakawa Sachiyo; Yamashita Hironori; Ajiki Tetsuo; Fukumoto Takumi; Ku Yonson

来源：Surgery Today, 2015, 45(12): 1567-1571.

DOI：10.1007/s00595-014-1069-z

• Acute graft-versus-host disease
• Pancreas transplantation
• HLA matching

Acute graft-versus-host-disease (aGVHD) is a rare complication in the setting of pancreas-kidney transplantation (PKT). We herein describe the case of a 37-year-old male with severe type 1 diabetes with chronic renal failure who received simultaneous PKT from a female donor. Diarrhea developed on postoperative day (POD) 10. Subsequently, fever and liver dysfunction occurred on POD 32. Skin rashes appeared with pain and itching on his trunk and extremities on POD 40. As pancytopenia occurred on POD 63, bone marrow biopsies demonstrated profound hypoplastic marrow. On POD 69, we eventually made a definitive diagnosis of aGVHD because skin biopsies revealed the XX chromosome signal in a fluorescence in situ hybridization analysis. Thereafter, 100 mg of prednisolone was administered for 5 days. Although every symptom was temporarily improved, on POD 156, the patient expired from the septic pneumonia without any effects of antibiotics. Clinician should be aware that PKT has the potential to induce aGVHD.

• 出版日期2015-12