Book contents
- Frontmatter
- Contents
- List of Contributors
- Foreword by Daniel R. Salomon
- Foreword by Robin Marks
- Foreword by Kathy Schwab
- Preface
- Acknowledgments
- SECTION ONE TRANSPLANT DERMATOLOGY: AN EVOLVING DYNAMIC FIELD
- Section Two Transplant Medicine and Dermatology
- Section Three Pathogenic Factors in Transplant Dermatology
- Section Four Cutaneous Effects of Immunosuppressive Medications
- Section Five Infectious Diseases of the Skin in Transplant Dermatology
- Section Six Benign and Inflammatory Skin Diseases in Transplant Dermatology
- 15 The Effects of Transplantation on Preexisting Dermatoses
- 16 Porokeratosis in Organ Transplant Recipients
- 17 Benign Cutaneous Neoplasms in Organ Transplant Recipients
- 18 Anogenital Cutaneous Disease in Organ Transplant Recipients
- 19 Cutaneous Graft versus Host Disease after Solid Organ Transplantation
- Section Seven Cutaneous Oncology in Transplant Dermatology
- Section Eight Special Scenarios in Transplant Cutaneous Oncology
- Section Nine Educational, Organizational, and Research Efforts in Transplant Dermatology
- Index
19 - Cutaneous Graft versus Host Disease after Solid Organ Transplantation
from Section Six - Benign and Inflammatory Skin Diseases in Transplant Dermatology
Published online by Cambridge University Press: 18 January 2010
- Frontmatter
- Contents
- List of Contributors
- Foreword by Daniel R. Salomon
- Foreword by Robin Marks
- Foreword by Kathy Schwab
- Preface
- Acknowledgments
- SECTION ONE TRANSPLANT DERMATOLOGY: AN EVOLVING DYNAMIC FIELD
- Section Two Transplant Medicine and Dermatology
- Section Three Pathogenic Factors in Transplant Dermatology
- Section Four Cutaneous Effects of Immunosuppressive Medications
- Section Five Infectious Diseases of the Skin in Transplant Dermatology
- Section Six Benign and Inflammatory Skin Diseases in Transplant Dermatology
- 15 The Effects of Transplantation on Preexisting Dermatoses
- 16 Porokeratosis in Organ Transplant Recipients
- 17 Benign Cutaneous Neoplasms in Organ Transplant Recipients
- 18 Anogenital Cutaneous Disease in Organ Transplant Recipients
- 19 Cutaneous Graft versus Host Disease after Solid Organ Transplantation
- Section Seven Cutaneous Oncology in Transplant Dermatology
- Section Eight Special Scenarios in Transplant Cutaneous Oncology
- Section Nine Educational, Organizational, and Research Efforts in Transplant Dermatology
- Index
Summary
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.
- Type
- Chapter
- Information
- Skin Disease in Organ Transplantation , pp. 131 - 134Publisher: Cambridge University PressPrint publication year: 2008