Graft-verse-host disease after liver transplantation: A report of two cases and review of literature

Table 1 STR system alleles of peripheral blood and normal skin after transplantation

STR alleles	Skin alleles	Peripheral blood alleles
Amelogenin	X, Y	X, Y
D5S818	10, 11	10, 11, 12
FGA	24, 24	23, 24, 25
D3S1358	15, 15	15, 15
TH01	9, 9	9, 9
D13S317	11, 14	8, 11,12, 14
D16S539	9, 11	9, 11, 14
D2S1338	24, 25	19, 24, 25, 26
D8S1179	10, 14	10, 13, 14
D21S11	30, 30	29, 30, 31
D7S820	10, 11	10, 11, 12
CSF1PO	10, 12	10, 12
D19S433	14.2, 15.2	14, 14.2, 15.2
vWA	18, 19	17, 18, 19
TPOX	8, 9	9, 11, 12
D18S51	20, 21	12, 13, 20, 21

STR: Short tandem repeat.

Table 2 General data of the patients, onset of GVHD and diagnostic methods

Case	Gender	Age (yr)	Indication for LTx	Onset of GVHD	Diagnostic method
1	M	47	HCC	PD28 (rash)	Clinical diagnosis
2	M	58	HCC	PD27 (fever)	Clinical diagnosis
3	F	58	LC	PD25 (fever)	HLA typing by PCR-SSP
4	M	48	LC	PD21 (fever)	Clinical diagnosis
5	M	69	LC	PD21 (fever)	HLA typing by PCR-SSP
6	M	43	LC and HCC	PD27 (fever)	Clinical diagnosis

HCC: Hepatocellular carcinoma; LC: Lliver cirrhosis; HLA: Human leukocyte antigens; PCR-SSP: PCR-sequence specific primer; PD: Post-transplantation day.

Table 3 Treatment, time point of treatment and patient outcome

Case	Treatment	Time point of treatment after onset (d)	Outcome
1	Decreased immunosuppressant; G-CSF; IVIG	16	Death, infection
2	Decreased immunosuppressant; Methylprednisolone 80 mg × 10 d, then taper rapidly; G-CSF; IVIG	6	Death, gastrointestinal bleeding, infection, MOF
3	Decreased immunosuppressant; Methylprednisolone 80 mg × 10 d, then taper rapidly; G-CSF; ATG; IVIG	16	Death, gastrointestinal bleeding, infection, ARDS
4	Decreased immunosuppressant; Methylpredprednisolone impulse treatment, then taper; G-CSF	5	Death, gastrointestinal bleeding, infection, MOF
5	Discontinued immunosuppressant; Methylprednisolone impulse 480 mg/d, then taper; G-CSF; IVIG	6	Death, infection, gastrointestinal bleeding, respiratory failure
6	Non-specific treatment	?	Death, infection

G-CSF: Granulocyte colony-stimulating factor; IVIG: Intravenous immunoglobin therapy; MOF: Multiple organ failure; ARDS: Acute respiratory distress syndrome.