Late onset of severe graft-versus-host disease in a pediatric liver transplant recipient

We report the management of a patient with the late onset of chronic graft- versus-host disease (GVHD) after orthotopic liver transplantation. GVHD is a rare complication of solid organ transplants that usually presents early after transplantation and is fatal in the majority of cases. Our patient di ffers from the typical patient with GVHD in that the onset of her disease w as very late. Although most treatment to date consisted of an increase in i mmunosuppressive therapy, our patient showed an excellent response to a red uction. This resulted in the abatement of the symptoms of GVHD and the pres ervation of her allograft function.