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KMID : 0371320110800000036
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Journal of the Korean Surgical Society
2011 Volume.80 No. 0 p.36 ~ p.39
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Graft-versus-host disease after kidney transplantation
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Kim Jong-Man
Kim Sung-Joo
Joh Jae-Won
Kwon Choon-Hyuck
Jang Kee-Taek
An Jung-Suk
Ki Chang-Seok
Kang Eun-Suk
Shin Mill-Jae
Kim Bok-Nyeo
Lee Suk-Koo
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Abstract
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Graft-versus-host disease (GVHD) is a rare complication after kidney transplantation. We describe a 62-year-old female with end-stage renal disease due to hypertension. She received a kidney with 4 mismatched human leukocyte antigen (HLA) out of 6 HLA - A, B, DR from a deceased donor. After the procedure, the patient showed watery diarrhea on postoperative day (POD) 45. An endoscopic biopsy of the colon revealed some apoptotic cells consistent with GVHD. Thrombocytopenia was gradually developed on POD 54. She received steroid pulse therapy, and thrombocytopenia did not progress. However, pneumonia, renal failure, and cardiac failure occurred. She died due to multiple organ failure. We must consider GVHD in renal transplant recipients without homozygous or identical HLA, who had only watery diarrhea without other typical GVHD symptoms such as skin rash and fever, although GVHD is rare in renal transplant recipients.
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KEYWORD
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Graft-versus-host disease, Human leukocyte antigen, Kidney donation, Kidney transplantation
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