Allogeneic liver transplantation for hepatic veno-occlusive disease after bone marrow transplantation : clinical and immunological considerations

• Published in: Bone marrow transplantation (Basingstoke) Vol. 16; no. 3; pp. 473 - 478
• Main Authors: SCHLITT, H. J, TISCHLER, H. J, RINGE, B, RADDATZ, G, MASCHEK, H, DIETRICH, H, KUSE, E, PICHLMAYR, R, LINK, H
• Format: Journal Article
• Language: English
• Published: Basingstoke Nature Publishing Group 01.09.1995
• Subjects: Acute Disease; Adult; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Bone Marrow Transplantation - adverse effects; Bone marrow, stem cells transplantation. Graft versus host reaction; Graft vs Host Disease - etiology; Hepatic Veno-Occlusive Disease - etiology; Hepatic Veno-Occlusive Disease - immunology; Hepatic Veno-Occlusive Disease - therapy; Humans; Killer Cells, Natural - immunology; Leukemia, Myeloid - surgery; Liver Transplantation - immunology; Male; Medical sciences; T-Lymphocytes - immunology; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Transplantation, Homologous; Human; Venoocclusive disease; Portal circulation disease; Acute; Liver; Homograft; Cardiovascular disease; Malignant hemopathy; Transplantation; Homotransplantation; Vascular disease; Case study; Treatment; Surgery; Young adult; Bone marrow; Digestive diseases; Complication; Graft; Chimerism; Acute myelocytic leukemia
• ISSN: 0268-3369; 1476-5365

Veno-occlusive disease (VOD) is a frequent complication early after bone marrow transplantation. In cases of severe liver failure treatment by allogeneic liver transplantation is possible. We report the clinical and immunological course of a patient after bone marrow transplantation for AML and subsequent allogeneic liver transplantation for severe hepatic VOD. After liver transplantation the patient recovered well clinically. Early after liver transplantation he had large numbers of liver donor T and NK lymphocytes in his circulation. He had no liver graft rejection, but he developed mild acute GVHD which was caused by liver graft-derived T lymphocytes. Two years after transplantation he had persistent microchimerism with donor liver cells detectable in his bone marrow. Now 36 months after transplantation, the patient has no evidence of recurrent leukemia, stable liver function, and no signs of graft-versus-host disease or bone marrow dysfunction.