Novel Application of Extracorporeal Photopheresis as Treatment of Graft-versus-Host Disease Following Liver Transplantation

A 48-year-old man with hepatitis C virus (HCV) cirrhosis complicated by hepatocellular carcinoma underwent liver transplantation. His course was complicated by fever, diarrhea, abdominal pain, and pancytopenia. He developed a diffuse erythematous rash, which progressed to erythroderma. Biopsies of t...

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Bibliographic Details
Published in:ACG case reports journal 2017-03, Vol.4 (1), p.e48
Main Authors: Brown, Timothy J, Gentry, Cathy, Hammer, Suntrea T G, Hwang, Christine S, Vusirikala, Madhuri, Patel, Prapti A, Matevosyan, Karén, Tujios, Shannan R, Mufti, Arjmand R, Collins, Robert H
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Language:English
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Case Report
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Summary:A 48-year-old man with hepatitis C virus (HCV) cirrhosis complicated by hepatocellular carcinoma underwent liver transplantation. His course was complicated by fever, diarrhea, abdominal pain, and pancytopenia. He developed a diffuse erythematous rash, which progressed to erythroderma. Biopsies of the colon and skin were consistent with acute graft-versus-host disease. Donor-derived lymphocytes were present in the peripheral blood. The patient was treated with corticosteroids and cyclosporine; however, he had minimal response to intensive immunosuppressive therapy. Extracorporeal photopheresis was initiated as a salvage therapy. He had a dramatic response, and his rash, diarrhea, and pancytopenia resolved. He is maintained on minimal immunosuppression 24 months later.
ISSN:2326-3253
2326-3253
DOI:10.14309/crj.2017.48