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Pathology - Graft Versus Host Disease
This reaction is a potential complication in bone marrow and liver transplants and is the result of T lymphocytes from donor transplant product perceiving the host tissues as foreign. The responding donor T cells activate CD4 + and CD8 + T cells in the host, inducing lymphocytic infiltration of the skin, GI tract, and liver. Damage to these organs creates the distinctive clinical signs including dermatitis, crampy stomach pain with bloody diarrhea and/or anorexia, cholestasis producing jaundice and probably hepatocellular necrosis, as well as fever. Severity of symptoms predicts mortality. The reaction may occur in days to weeks following transplant. Posttransplant immunosuppression and ways to eliminate T cells from donor tissue has lowered the incidence, although it is still relatively common. The conventional treatment consists of injectable glucocorticoids, which require careful tapering.
This reaction is a potential complication in bone marrow and liver transplants and is the result of T lymphocytes from donor transplant product perceiving the host tissues as foreign. The responding donor T cells activate CD4 + and CD8 + T cells in the host, inducing lymphocytic infiltration of the skin, GI tract, and liver. Damage to these organs creates the distinctive clinical signs including dermatitis, crampy stomach pain with bloody diarrhea and/or anorexia, cholestasis producing jaundice and probably hepatocellular necrosis, as well as fever. Severity of symptoms predicts mortality. The reaction may occur in days to weeks following transplant. Posttransplant immunosuppression and ways to eliminate T cells from donor tissue has lowered the incidence, although it is still relatively common. The conventional treatment consists of injectable glucocorticoids, which require careful tapering.
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