Cutaneous Graft versus Host Disease in Pediatric Multivisceral Transplantation

  title={Cutaneous Graft versus Host Disease in Pediatric Multivisceral Transplantation},
  author={Marta Feito-Rodr{\'i}guez and Ra{\'u}l de Lucas-Laguna and Cristina G{\'o}mez-Fern{\'a}ndez and Elena Sendagorta-Cud{\'o}s and Elena Collantes and Mar{\'i}a Jos{\'e} Beato and Esther Ramos Boluda},
  journal={Pediatric Dermatology},
Abstract:  Multivisceral transplantation (MvTx) is the concurrent transplantation of the stomach, pancreaticoduodenal complex, and intestine, with or without the liver. Its use is increasing worldwide as it has been considered as a therapy for patients with functional disturbance of several organs. Graft‐versus‐host disease (GvHD) has been a relevant clinical problem in MvTx ever since the procedure was first performed, but little has been reported about its specific cutaneous features. Our… 

Current status of graft-versus-host disease after intestinal transplantation

Graft-versus-host disease (GVHD) is a serious complication that can occur after solid organ and allogenic HSCT and, to date, no consensus has been achieved for a single agent second-line therapy.

Graft Versus Host Disease After Intestinal Transplantation: A Single-center Experience

Although GVHD risk is mainly recipient-driven, changes in donor selection and immunosuppression practice may reduce incidence and improve survival.

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Novel therapies may offer hope in the future, but currently there is limited evidence for their efficacy in the context of intestinal or liver transplantation.

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  • Medicine
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  • 2017
GvHD in paediatric liver transplantation is difficult to treat and has a high mortality, but better recognition and understanding with novel therapies available offer hope for the future.

Association of Alemtuzumab Induction With a Significantly Lower Incidence of GVHD Following Intestinal Transplantation: Results of 445 Consecutive Cases From a Single Center

Cox stepwise regression was used to determine the significant multivariable predictors of the hazard rate of developing biopsy-proven GVHD during the first 60 months posttransplant among 445 consecutive intestinal transplant cases at the authors' center since 1994 and results remained unchanged even after accounting for the propensity to receive alemtuzumab induction.

Severe Skin Complications After Small Bowel Transplantation: Graft-Versus-Host Disease, DRESS, Virus, or Drug Toxicity?

Background Severe skin problems are uncommon after small bowel transplantation. Differential diagnosis includes drug reactions, infections, graft-versus-host disease (GVHD), and mixed diseases. Early

Therapeutic Apheresis in Transplantology

Evidence is found of the need for wider application of apheresis technologies in transplantation, among them plasmapheresis plays the leading role, which can be used to block both acute and chronic rejection of the transplanted organs as well as transplant-against-host reactions, giving less toxic doses of drugs.

Donor’s graft ex vivo T‐cell depletion with fludarabine reduces graft‐versus‐host disease signs and improves survival after intestinal transplantation – an experimental study

It is concluded that active modification of the intestinal leukocyte composition is advantageous in the ITx animal model and immunosuppression with fludarabine during the surgical procedure protects bowel recipients from GvHD and improves overall post‐transplant survival.



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Young children, multivisceral graft recipients, and particularly those with splenectomy are at high risk of developing GVHD after transplantation, which is a fatal and progressive complication of small bowel transplantation.

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The majority of cases of GVHD resolved with steroid administration and optimization of tacrolimus immunosuppression and the clinical course and outcome of patients with graft vs. host disease after intestinal transplantation (ITx) were analyzed.

[Cutaneous graft-versus-host disease].

  • S. Karrer
  • Medicine, Biology
    Der Hautarzt; Zeitschrift fur Dermatologie, Venerologie, und verwandte Gebiete
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In this review, the various cutaneous manifestations of GvHD, the histopathologic features, prophylaxis and therapy of acute and chronic Gv HD are discussed in light of the recent literature.

Cutaneous Graft-versus-Host Disease: A Guide for the Dermatologist

The updated knowledge on this disease focused for the dermatologist is summarized and the recent consensus documents on the various aspects of chronic GVHD of the National Institute of Health are emphasized.

The current status of multivisceral transplantation.

MVTx has been the optimal therapy for the intestine with liver failure and/or failure of several other organs, despite many difficulties in preventing rejection and infection.

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The results show that the multivisceral graft seems to facilitate engraftment of transplanted organs and raises the possibility that there is a degree of immunologic protection afforded by this procedure.

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Intestinal and multivisceral transplantation

The future of intestinal transplantation and multivisceral transplantation appears promising, but the major challenge is early recognition of acute rejection in order to prevent graft loss, opportunistic infections associated to complications, post-transplant lymphoproliferative disease and graft versus host disease and consequently, improve results in the long run.

Toxic epidermal necrolysis after bone marrow transplantation: study of nine cases.