A CASE OF CHRONIC GRAFT-VERSUS-HOST DISEASE FOLLOWING LIVING-RELATED DONOR KIDNEY-TRANSPLANTATION

A 25-year-old man with a 2.5-year history of maintenance hemodialysis underwent a living-related donor (father) kidney transplantation. He w as free from acute rejection, but 8 months after the kidney transplant ation, he complained of malaise and fever which were accompanied by er uptions on the face, fingers, and hips which resembled symptoms seen i n patients suffering from systemic vasculitis. Skin biopsy findings we re compatible with those of chronic graft-versus-host disease (GVHD). The human leukocyte antigen (HLA) family study disclosed that the dono r's HLA haplotype was homozygous and identical to one of the recipient 's HLA haplotypes which indicated that the host would not resist engra ftment. On the basis of these findings, a diagnosis of chronic GVHD wa s made, and increasing doses of immunosuppressants resulted in a resol ution of these symptoms. Our report is the first describing GVHD that developed in a patient undergoing related-donor kidney transplantation .