Alex M. DePaoli, MD; Jacob Bitran, MD
To the Editors: We offer another case in support of the supposition by Collins and colleagues (1) that graft-versus-host disease (GVHD) in liver transplantation is more common than previously thought.
An 18-year-old white woman (A-positive) received an ABO-mismatched orthotopic liver transplant from a previously healthy man (O-positive) for cryptogenic cirrhosis after her first transplant failed secondary to biliary obstruction. The procedure was uncomplicated. Her hemoglobin fell rapidly from 10.2 mg/dL to 6.6 mg/dL between days 5 and 9 after surgery without evidence of bleeding. High titers of anti-A antibodies were found in the patient's serum, believed to be
DePaoli AM, Bitran J. Graft-versus-Host Disease and Liver Transplantation. Ann Intern Med. ;117:170–171. doi: 10.7326/0003-4819-117-2-170_1
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Published: Ann Intern Med. 1992;117(2):170-171.
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