ObjectiveTo investigate characteristics and research progress of graft-versus-host disease following liver transplantation, and provide guidance for diagnosis and treatment of this disease. MethodsThe relevant literatures on graft-versus-host disease following liver transplantation were reviewed, and the related articles on the reference of bone marrow transplantation and other solid organ transplantation were summarized. ResultsThe incidence of graft-versus-host disease following liver transplantation was 0.1% to 2%, and the mortality was > 75%. The pathogenesis was not clear, and the diagnosis was based on the clinical symptoms, the histological examination, and the evidence of human leukocyte antigen(HLA) or DNA from donor lymphocytes. There were numerous treatment options, most of which, however, could not work effectively. A unified standard was needed. ConclusionsGraft-versus-host disease is a rare complication following liver transplantation, and prognosis is very poor. On one hand, it should be paid more attention to prevention before transplantation, such as the large age gap between donor and recipient, the similarity of HLA matching and so on. On the other hand, it should be strengthened the prevention awareness and actively carry out tissue biopsy, HLA typing, and chimera study. More studies from multiple centers should be carried out to actively explore the criteria for clinical treatment.
ObjectiveTo investigate the decision of combined liver and kidney transplantation (CLKT) after renal transplantation, provide surgical therapeutic experience for those patients with liver and renal insufficiencies and hepatorenal syndrome and summarize the risk factors, demerits and merits, and operative indications of CLKT. MethodsThe data of three successful CLKT cases of our centre from Feb. 2014 to Jan 2015 were retrospectively analyzed, and these three patients had kidney transplantation before. We also reviewed the latest associated literatures. ResultsThree patients got successful operations of CLKT and had very good recovery of renal function several days ofter operaton. Two of them discharged a few weeks after surgery, and one of these two patients got severe pulmonary infection of fungus two month after CLKT but recovered under proper therapy finally. The third patient died of severe mixed infection one month after CLKT. ConclusionsThe surgical techniques and rejection are not the main impact factor to the prognosis of CLKT after renal transplantation. Infection is the biggest trouble to which we should pay most of our attention. We should decide whether to do synchronous or nonsynchronous CLKT according to the situation before surgery. Moreover, the systematic therapy administration after CLKT is very necessary for the patients' long-term survival.