FISH diagnosis of acute graft-versus-host disease following living-related liver transplant

Kazunori Kanehira, Douglas L. Riegert-Johnson, Dong Chen, Lawrence E. Gibson, Stephen D. Grinnell, Gopalrao V. Velgaleti

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16 Scopus citations

Abstract

Acute graft-versus-host disease (GVHD) is an uncommon but often fatal complication following liver transplant. We describe a GVHD case in which a female patient with primary biliary cirrhosis underwent a living-related liver transplant from her son. The human leukocyte antigen typing of the donor was homozygous at all loci. The recipient's human leukocyte antigen type was haplo-identical to that of the donor. A bone marrow aspirate performed for pancytopenia revealed a severely hypoplastic marrow. Fluorescent in situ hybridization (FISH) using X- and Y-chromosome probes demonstrated that 80% of marrow cells were of donor origin. Comparison of Giemsa-stained cell morphology and FISH showed that the erythroid precursor cells were predominantly of male pattern (XY). This report is one of only a few studies that prove the migration of a donor's hematopoietic stem cells to a recipient's bone marrow. We demonstrated that FISH analysis using sex chromosome probes is useful to confirm a diagnosis of GVHD following organ transplantation from a donor of the opposite sex. We also showed that donor hematopoietic stem cells in a liver graft can migrate to the recipient's bone marrow. We suggest that FISH is a rapid and reliable test for confirming the diagnosis of GVHD in a peripheral blood or skin biopsy sample.

Original languageEnglish (US)
Pages (from-to)355-358
Number of pages4
JournalJournal of Molecular Diagnostics
Volume11
Issue number4
DOIs
StatePublished - Jul 2009

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ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Molecular Medicine

Cite this

Kanehira, K., Riegert-Johnson, D. L., Chen, D., Gibson, L. E., Grinnell, S. D., & Velgaleti, G. V. (2009). FISH diagnosis of acute graft-versus-host disease following living-related liver transplant. Journal of Molecular Diagnostics, 11(4), 355-358. https://doi.org/10.2353/jmoldx.2009.080172