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Graft-Versus-Host Disease After Liver Transplantation: Diagnostic and Therapeutic Challenges

Year: 2026

Type: article

Abstract: Graft-versus-host disease (GVHD) is a rare but severe complication following solid organ transplantation, with limited literature guiding diagnosis and management. We present a 55-year-old man with alcohol-associated end-stage liver disease who developed GVHD approximately one month after orthotopic liver transplantation (LT). He was initially admitted for persistent fever and concern for sepsis, with subsequent development of progressive pancytopenia and a non-pruritic maculopapular rash with mucosal involvement. Skin biopsy performed on hospital day 10 supported the diagnosis of GVHD, and donor chimerism testing demonstrated 70% donor-derived CD3+ lymphocytes. He improved with high-dose intravenous methylprednisolone and remained clinically stable on ruxolitinib maintenance therapy at two-month post-discharge follow-up. GVHD following LT should be considered early in patients with non-specific presentations, such as unexplained fever, cytopenias, rash, or mucosal findings. Early recognition, tissue biopsy, and chimerism testing may facilitate timely intervention and improve outcomes in this rare condition associated with high mortality.

Source: Cureus

DOI: 10.7759/cureus.110988

Authors: Jerry Qi, Kareem Latif, Leo Sakai, Nidhi Kejriwal, Amy Schill

Institution: Loma Linda University Medical Center

Language: English

Topic: Hematopoietic Stem Cell Transplantation

Subfield: Hematology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W7164933444