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Mediastinal irradiation for graft-versus-host disease in a heart-lung transplant recipient.

Abstract
Graft-versus-host disease in solid organ transplantation is very rare, but the prognosis is poor when the condition causes pancytopenia. We report a case of graft-versus-host disease in a heart-lung transplant recipient who at 2 weeks after transplantation had development of features of graft-versus-host disease, including bone marrow aplasia, that could not be attributed to drugs or viral infections. The diagnosis was confirmed by skin biopsy and demonstration of chimerism of peripheral lymphocytes. Augmentation of immunosuppression with intravenous methylprednisolone resulted in improvement in liver function but had no effect on the pancytopenia. Mediastinal irradiation was given with increase in both white blood cell and platelet counts. Unfortunately the patient eventually died of gastrointestinal bleeding and fungemia.
AuthorsE M Chau, J Lee, W W Yew, C S Chiu, E P Wang
JournalThe Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation (J Heart Lung Transplant) Vol. 16 Issue 9 Pg. 974-9 (Sep 1997) ISSN: 1053-2498 [Print] United States
PMID9322150 (Publication Type: Case Reports, Journal Article)
Topics
  • Adult
  • Eisenmenger Complex (immunology, pathology, surgery)
  • Fatal Outcome
  • Female
  • Graft vs Host Disease (pathology, radiotherapy)
  • Heart-Lung Transplantation (immunology, pathology)
  • Humans
  • Leukocyte Count (radiation effects)
  • Liver (pathology)
  • Lung (pathology)
  • Mediastinum
  • Platelet Count (radiation effects)
  • Skin (pathology)

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