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Graft-versus-host disease after simultaneous pancreas-kidney transplantation

대한이식학회지 2020년 34권 1호 p.62 ~ 65
이주한 ( Lee Ju-Han ) - Yonsei University College of Medicine Severance Hospital Department of Surgery

김명수 ( Kim Myoung-Soo ) - Yonsei University College of Medicine Severance Hospital Department of Surgery
허규하 ( Huh Kyu-Ha ) - Yonsei University College of Medicine Severance Hospital Department of Surgery
주동진 ( Joo Dong-Jin ) - Yonsei University College of Medicine Severance Hospital Department of Surgery
이재근 ( Lee Jae-Geun ) - Yonsei University College of Medicine Severance Hospital Department of Surgery
김순일 ( Kim Soon-Il ) - Yonsei University College of Medicine Severance Hospital Department of Surgery

Abstract


Graft-versus-host disease (GVHD) is rare complication after simultaneous pancreas-kidney transplantation (SPK). Here, we present a rare case of GVHD that developed in a SPK recipient. A 38-year-old female patient with end-stage renal disease due to type 1 diabetes mellitus underwent SPK from a deceased female donor. Four months after transplantation, she was readmitted with fever and abdominal pain and computed tomography revealed a retroperitoneal abscess. While being treated for the retroperitoneal abscess by percutaneous drainage and antibiotics, the patient developed skin rash and diarrhea. A skin biopsy performed at the time showed vacuolization and peri-venular lymphocytic infiltration compatible with GVHD. High-dose steroids resulted in complete remission of GVHD, and the patient was discharged after 2 weeks of treatment. This case demonstrates that early diagnosis of GVHD followed by timely treatment may led to a favorable outcome, and cautions that GVHD can occur in SPK patients.

키워드

Graft-versus-host disease; Pancreas transplantation; Kidney transplantation
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