Graft-versus-host disease in paediatric liver transplantation: A review of the literature.

BACKGROUND: Graft versus host disease (GvHD) is a major complication after haematopoietic stem-cell transplantation but much less common after solid organ transplant and rare after liver transplantation. Early symptoms can resemble viral infections or drug-reactions and thus it may be under-investigated. There are no standard treatment guidelines for GvHD after paediatric liver transplantation.

OBJECTIVES: To review all cases of GvHD reported to date after paediatric liver transplant.

METHODS: Literature review of all English-language full-text articles published between 1990 and 2017Results. Case series articles and case reports were reviewed and collated. Symptoms, diagnostic investigations, treatments and outcomes were described for all reported cases.

CONCLUSION: GvHD in paediatric liver transplantation is difficult to treat and has a high mortality, but better recognition and understanding with novel therapies available offer hope for the future.