Kupffer cell erythrophagocytosis and graft-versus-host hemolysis in liver transplantation

Gastroenterology
P A ClavienG A Levy

Abstract

Graft-versus-host hemolysis (GVHH) syndrome develops in approximately half of patients undergoing ABO-unmatched liver transplantation. The clinical and laboratory presentations of GVHH syndrome often mimic acute rejection, leading to liver biopsy for definitive diagnosis. The purpose of this study was to investigate if there are specific histological findings that permit diagnosis of GVHH syndrome and to assess the relationship between GVHH syndrome and rejection. Clinical and laboratory evidence of GVHH syndrome, results of liver biopsy, and clinical outcome were assessed in 30 ABO-unmatched liver transplant recipients. Biopsy results were compared with those of two control groups consisting of patients who had normal liver test findings (protocol biopsy) and rejection. Sixteen of the 30 patients (53%) had evidence of GVHH syndrome. Erythrophagocytosis was noted in each biopsy specimen, and the degree of phagocytosis correlated significantly with the amount of blood given after postoperative day 5 (r = 0.9; P < 0.02). Electron-microscopic studies performed randomly in 5 patients showed that the red cells were located in Kupffer cells. In contrast, erythrophagocytosis was minimal in the two control groups. Despite an incidence ...Continue Reading

Citations

May 23, 2002·Transplantation·Michael A ReesPeter J Friend
Mar 30, 2004·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Katarína VajdováPierre-Alain Clavien
Nov 28, 2000·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·M SelznerP A Clavien

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