Graft-versus-host disease after intestinal and multivisceral transplantation

Guosheng Wu, Gennaro Selvaggi, Seigo Nishida, Jang Moon, Eddie Island, Phillip Ruiz, Andreas G. Tzakis

Research output: Contribution to journalArticle

51 Citations (Scopus)

Abstract

Background.: Graft-versus-host-disease (GVHD) is a rare complication but carries a high mortality after transplantation. We retrospectively evaluated the incidence, risk factors and impact of this complication on the survival outcome of intestinal transplantation at a single center. Methods.: 241 patients who underwent intestinal transplantation between March 1994 and July 2007 were analyzed for evidence of GVHD. A diagnosis of GVHD was based on clinical presentations and confirmed by histological findings. Results.: Of the 241 patients, 22 (9.1%) were diagnosed as GVHD. The median time of GVHD onset was 75 days (range, 14-1,408). The incidence of GVHD was significantly higher in young children than in adults (13.2 versus 4.4%, P=0.05). The multivisceral graft recipients were more likely to develop GVHD compared with those of isolated small bowel (12.4% versus 4.6%, P=0.05). The presence of recipient splenectomy was significantly associated with the incidence of GVHD (P=0.03). The inclusion of the spleen in the multivisceral grafts tended to be at an increased risk of GVHD compared with the group without the spleen transplant (12.3% versus 7.9%, P=0.43). A total of 16 patients with GVHD died during the entire follow-up. Infection was the leading cause of death in 55% patients. Conclusions.: GVHD is a fatal and progressive complication of small bowel transplantation. Younger children, multivisceral graft recipients, and particularly those with splenectomy are at high risk of developing GVHD after transplantation.

Original languageEnglish
Pages (from-to)219-224
Number of pages6
JournalTransplantation
Volume91
Issue number2
DOIs
StatePublished - Jan 27 2011

Fingerprint

Graft vs Host Disease
Transplantation
Transplants
Splenectomy
Incidence
Spleen
Cause of Death

Keywords

  • Complications
  • Graft-versus-host disease
  • Small bowel transplantation

ASJC Scopus subject areas

  • Transplantation

Cite this

Graft-versus-host disease after intestinal and multivisceral transplantation. / Wu, Guosheng; Selvaggi, Gennaro; Nishida, Seigo; Moon, Jang; Island, Eddie; Ruiz, Phillip; Tzakis, Andreas G.

In: Transplantation, Vol. 91, No. 2, 27.01.2011, p. 219-224.

Research output: Contribution to journalArticle

Wu, Guosheng ; Selvaggi, Gennaro ; Nishida, Seigo ; Moon, Jang ; Island, Eddie ; Ruiz, Phillip ; Tzakis, Andreas G. / Graft-versus-host disease after intestinal and multivisceral transplantation. In: Transplantation. 2011 ; Vol. 91, No. 2. pp. 219-224.
@article{f393204b08204fc3895f2e30950a556e,
title = "Graft-versus-host disease after intestinal and multivisceral transplantation",
abstract = "Background.: Graft-versus-host-disease (GVHD) is a rare complication but carries a high mortality after transplantation. We retrospectively evaluated the incidence, risk factors and impact of this complication on the survival outcome of intestinal transplantation at a single center. Methods.: 241 patients who underwent intestinal transplantation between March 1994 and July 2007 were analyzed for evidence of GVHD. A diagnosis of GVHD was based on clinical presentations and confirmed by histological findings. Results.: Of the 241 patients, 22 (9.1{\%}) were diagnosed as GVHD. The median time of GVHD onset was 75 days (range, 14-1,408). The incidence of GVHD was significantly higher in young children than in adults (13.2 versus 4.4{\%}, P=0.05). The multivisceral graft recipients were more likely to develop GVHD compared with those of isolated small bowel (12.4{\%} versus 4.6{\%}, P=0.05). The presence of recipient splenectomy was significantly associated with the incidence of GVHD (P=0.03). The inclusion of the spleen in the multivisceral grafts tended to be at an increased risk of GVHD compared with the group without the spleen transplant (12.3{\%} versus 7.9{\%}, P=0.43). A total of 16 patients with GVHD died during the entire follow-up. Infection was the leading cause of death in 55{\%} patients. Conclusions.: GVHD is a fatal and progressive complication of small bowel transplantation. Younger children, multivisceral graft recipients, and particularly those with splenectomy are at high risk of developing GVHD after transplantation.",
keywords = "Complications, Graft-versus-host disease, Small bowel transplantation",
author = "Guosheng Wu and Gennaro Selvaggi and Seigo Nishida and Jang Moon and Eddie Island and Phillip Ruiz and Tzakis, {Andreas G.}",
year = "2011",
month = "1",
day = "27",
doi = "10.1097/TP.0b013e3181ff86ec",
language = "English",
volume = "91",
pages = "219--224",
journal = "Transplantation",
issn = "0041-1337",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

TY - JOUR

T1 - Graft-versus-host disease after intestinal and multivisceral transplantation

AU - Wu, Guosheng

AU - Selvaggi, Gennaro

AU - Nishida, Seigo

AU - Moon, Jang

AU - Island, Eddie

AU - Ruiz, Phillip

AU - Tzakis, Andreas G.

PY - 2011/1/27

Y1 - 2011/1/27

N2 - Background.: Graft-versus-host-disease (GVHD) is a rare complication but carries a high mortality after transplantation. We retrospectively evaluated the incidence, risk factors and impact of this complication on the survival outcome of intestinal transplantation at a single center. Methods.: 241 patients who underwent intestinal transplantation between March 1994 and July 2007 were analyzed for evidence of GVHD. A diagnosis of GVHD was based on clinical presentations and confirmed by histological findings. Results.: Of the 241 patients, 22 (9.1%) were diagnosed as GVHD. The median time of GVHD onset was 75 days (range, 14-1,408). The incidence of GVHD was significantly higher in young children than in adults (13.2 versus 4.4%, P=0.05). The multivisceral graft recipients were more likely to develop GVHD compared with those of isolated small bowel (12.4% versus 4.6%, P=0.05). The presence of recipient splenectomy was significantly associated with the incidence of GVHD (P=0.03). The inclusion of the spleen in the multivisceral grafts tended to be at an increased risk of GVHD compared with the group without the spleen transplant (12.3% versus 7.9%, P=0.43). A total of 16 patients with GVHD died during the entire follow-up. Infection was the leading cause of death in 55% patients. Conclusions.: GVHD is a fatal and progressive complication of small bowel transplantation. Younger children, multivisceral graft recipients, and particularly those with splenectomy are at high risk of developing GVHD after transplantation.

AB - Background.: Graft-versus-host-disease (GVHD) is a rare complication but carries a high mortality after transplantation. We retrospectively evaluated the incidence, risk factors and impact of this complication on the survival outcome of intestinal transplantation at a single center. Methods.: 241 patients who underwent intestinal transplantation between March 1994 and July 2007 were analyzed for evidence of GVHD. A diagnosis of GVHD was based on clinical presentations and confirmed by histological findings. Results.: Of the 241 patients, 22 (9.1%) were diagnosed as GVHD. The median time of GVHD onset was 75 days (range, 14-1,408). The incidence of GVHD was significantly higher in young children than in adults (13.2 versus 4.4%, P=0.05). The multivisceral graft recipients were more likely to develop GVHD compared with those of isolated small bowel (12.4% versus 4.6%, P=0.05). The presence of recipient splenectomy was significantly associated with the incidence of GVHD (P=0.03). The inclusion of the spleen in the multivisceral grafts tended to be at an increased risk of GVHD compared with the group without the spleen transplant (12.3% versus 7.9%, P=0.43). A total of 16 patients with GVHD died during the entire follow-up. Infection was the leading cause of death in 55% patients. Conclusions.: GVHD is a fatal and progressive complication of small bowel transplantation. Younger children, multivisceral graft recipients, and particularly those with splenectomy are at high risk of developing GVHD after transplantation.

KW - Complications

KW - Graft-versus-host disease

KW - Small bowel transplantation

UR - http://www.scopus.com/inward/record.url?scp=78751641946&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=78751641946&partnerID=8YFLogxK

U2 - 10.1097/TP.0b013e3181ff86ec

DO - 10.1097/TP.0b013e3181ff86ec

M3 - Article

VL - 91

SP - 219

EP - 224

JO - Transplantation

JF - Transplantation

SN - 0041-1337

IS - 2

ER -