TY - CHAP
T1 - Cutaneous graft versus host disease after solid organ transplantation
AU - Pacheco, Theresa R.
AU - Prescott, Christina Rapp
N1 - Publisher Copyright:
© Cambridge University Press 2008 and 2009.
Copyright:
Copyright 2015 Elsevier B.V., All rights reserved.
PY - 2008/1/1
Y1 - 2008/1/1
N2 - INTRODUCTION. Graft-versus-host disease (GVHD) is a complication usually associated with allogenic bone marrow transplantation, occurring in 40–80% of recipients. Rarely, GVHD can develop subsequent to solid organ transplantation, particularly after liver and small-bowel transplantation. It has been reported to occur in 1.2% (12/1082) to 1.5% (7/453) in two series of liver transplant recipients and 4.7% (6/128 adults) to 6.5% (8/122 children) of small-bowel transplant recipients. GVHD is rare after cardiac, lung, and renal transplantation, having been reported in only 2 heart/lung transplant patients, 4 lung transplant patients, and 1 kidney transplant patient. This chapter will focus on GVHD, which occurs in solid organ transplant recipients. PATHOGENESIS. For GVHD to occur, donor tissue containing immunocompetent T cells must be placed into an immunocompromised recipient possessing tissue antigens otherwise absent from the donor. The pathogenesis of GVHD is initiated prior to transplantation with damage to host tissue caused by underlying illness, therapeutic intervention, infection, or pretransplant conditioning. These insults can lead to host antigen presenting cell activation and release of tumor necrosis factor alpha, interleukin-1, and interleukin-6. Once the transplant occurs, these factors facilitate activation of donor T cells transferred with the allograft, which differentiate into T-helper 1 cells that secrete interferon-gamma and interferon-2. The net result of these events is activation of cytotoxic T cell lymphocytes, natural killer cells, and macrophages that attack host cells, primarily in the skin.
AB - INTRODUCTION. Graft-versus-host disease (GVHD) is a complication usually associated with allogenic bone marrow transplantation, occurring in 40–80% of recipients. Rarely, GVHD can develop subsequent to solid organ transplantation, particularly after liver and small-bowel transplantation. It has been reported to occur in 1.2% (12/1082) to 1.5% (7/453) in two series of liver transplant recipients and 4.7% (6/128 adults) to 6.5% (8/122 children) of small-bowel transplant recipients. GVHD is rare after cardiac, lung, and renal transplantation, having been reported in only 2 heart/lung transplant patients, 4 lung transplant patients, and 1 kidney transplant patient. This chapter will focus on GVHD, which occurs in solid organ transplant recipients. PATHOGENESIS. For GVHD to occur, donor tissue containing immunocompetent T cells must be placed into an immunocompromised recipient possessing tissue antigens otherwise absent from the donor. The pathogenesis of GVHD is initiated prior to transplantation with damage to host tissue caused by underlying illness, therapeutic intervention, infection, or pretransplant conditioning. These insults can lead to host antigen presenting cell activation and release of tumor necrosis factor alpha, interleukin-1, and interleukin-6. Once the transplant occurs, these factors facilitate activation of donor T cells transferred with the allograft, which differentiate into T-helper 1 cells that secrete interferon-gamma and interferon-2. The net result of these events is activation of cytotoxic T cell lymphocytes, natural killer cells, and macrophages that attack host cells, primarily in the skin.
UR - http://www.scopus.com/inward/record.url?scp=84928423793&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84928423793&partnerID=8YFLogxK
U2 - 10.1017/CBO9780511547379.023
DO - 10.1017/CBO9780511547379.023
M3 - Chapter
AN - SCOPUS:84928423793
SN - 0521870674
SN - 9780521870672
SP - 131
EP - 134
BT - Skin Disease in Organ Transplantation
PB - Cambridge University Press
ER -