{Reference Type}: Case Reports
{Title}: When donor T cells attack: The curious case of liver transplant-associated acute graft-versus-host-disease.
{Author}: Deschner M;Bastin DJ;Solh Z;Bosma K;Haddara W;Yang P;Broadbent R;Haig A;Keow J;Brahmania M;Xenocostas A;Deotare U;
{Journal}: Sci Prog
{Volume}: 105
{Issue}: 3
{Year}: Jul-Sep 2022
{Factor}: 1.512
{DOI}: 10.1177/00368504221117070
{Abstract}: Graft versus host disease is a rare but deadly complication of solid organ transplant. Clinical features of graft-versus-host-disease are non-specific, which may lead to delayed diagnosis as more common conditions including infections or drug reactions are considered. We describe a 54-year-old male patient who underwent liver transplantation for alcohol use disorder-related cirrhosis and developed acute graft-versus-host disease. Initial clinical presentation included dermatitis, bone marrow failure and enteritis. Results of skin biopsy and cytogenetic studies were consistent with liver transplant-associated acute graft-versus-host disease. The importance of this case is to highlight to transplant physicians and surgeons the challenges of diagnosing graft-versus-host-disease. In our case, pre-existing partnerships among the liver and hematopoietic stem cell transplant teams, transfusion medicine specialists, critical care specialists and facilitated timely communication relevant to confirming graft-versus-host disease. We propose an algorithm to assist in the workup of suspected graft-versus-host disease. Because this condition is characterized by high mortality, a high index of suspicion is imperative for prompt diagnosis and optimal management of the donor-recipient immune interaction when patients present with classic clinical features.