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25 February 2023: Original Paper

Detecting Donor-Derived DNA by Real-Time PCR in Recipients Suspected of Graft-Versus-Host-Diseases After Liver Transplantation: A Case Series and Literature Review

Changhee Ha 1ABCDEF* , Sang Jin Kim 234ABCDEF* , Jong Man Kim 2BE , Jae-Won Joh 2BE , Kee-Taek Jang 5BE , Gyu-Seong Choi 2ABCDE* , Eun-Suk Kang 1ABCDE*

DOI: 10.12659/AOT.938287

Ann Transplant 2023; 28:e938287

Table 2 Characteristics of patients with graft-versus-host disease after liver transplantation.

Case No.Age/sexDonor type (relationship/ MELD score)HLA type*Pre-LT CMV serology
RDRD
166/M38/FLiving (Daughter/10)A24, A33A33, A33R+/D+
B44, B46B44, B44
C1, C7C7, C7
DR7, DR8DR7, DR7
DQ1, DQ2DQ2, DQ2
249/M24/MDeceased (Unrelated/36)A2, A2A2, A11R+/D+
B13, B35B51, B62
DR11, DR12DR4, DR4
369/F43/MLiving (Son/13)A2, A11A2, A26R+/D+
B35, B39B35, B62
DR8, DR8DR8, DR15
** # ##
1Diarrhea (23)High dose steroid, TNF-α inhibitor (30)Yes (32)39.68KMR016 (D)
Rash (24)Neutropenia (28)KMR054 (D)
2Pancytopenia (29)Moderate-dose steroid, TNF-α inhibitor (38)Yes (41)78.38KMR033 (R)
Diarrhea (33)Rash (34)KMR037 (D)
3Pancytopenia (80)Moderate-dose steroid only (90)No4.76KMR009 (R)
Hematochezia & Diarrhea (84)KMR011 (R)KMR036 (R)KMR037 (R)KMR028 (D)KMR047 (D)KMR054 (D)
* HLA typing was performed with intermediate resolution sequence-specific oligonucleotide probe hybridization (One Lambda LABType™, Thermo Fisher Scientific Inc., Waltham, MA, USA);
** The first day of GVHD feature appearance after LT;
# The first day of GVHD treatment after LT;
## Mean fraction of donor-derived DNA representing donor-cell fraction among recipient cells in peripheral blood.
GVHD – graft-versus-host-disease; LT – liver transplantation; R – recipient; D – donor; MELD – Model-for-End-Stage Liver Disease; HLA – human leukocyte antigen; CMV – cytomegalovirus; ddDNA – donor-derived deoxyribonucleic acid; F – female; M – male; TNF-α – tumor necrosis factor α.

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Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358