Eur J Pediatr Surg 2007; 17(6): 412-415
DOI: 10.1055/s-2007-965812
Original Article

© Georg Thieme Verlag KG Stuttgart · New York

Prognostic Value of Skin Histology in GVHD after Intestinal Transplantation

T. Pintar1 , R. Zorc-Pleskovič3 , M. Alessiani2 , A. Milutinović3 , A. Pleskovič1
  • 1Abdominal Surgery Department, Medical Centre Ljubljana, Ljubljana, Slovenia
  • 2Department of Surgery, University of Pavia and IRCCS Polikliniko San Matteo, P. le Golgi 2, Pavia, Italy
  • 3Institute of Histology and Embryology, Medical Faculty, University Ljubljana, Ljubljana, Slovenija
Further Information

Publication History

received May 7, 2007

accepted after revision July 27, 2007

Publication Date:
11 December 2007 (online)

Abstract

Intestinal transplantation (Itx) is increasingly being performed to treat patients with irreversible intestinal failure. Acute graft-versus-host disease (GVHD) after Itx is a life-threatening complication which can progress to organ failure, systemic complications and death. The purpose of this study was to assess the diagnostic and prognostic role of histological changes as demonstrated by skin biopsy for acute GVHD after Itx. A porcine model of orthotropic Itx and bone marrow transplantation with tacrolimus-based immunosuppression was used to assess any correlation between acute graft cellular rejection and skin histological findings for the prediction of GVHD. Skin and small intestinal biopsies were histologically assessed on postoperative days 0, 15, 30, 45, and 60 and analyzed and classified as grade 1 to 4. A linear correlation was observed between the histological grading values of skin biopsy changes and the histological grading values of small intestinal biopsy changes (Kendall's tau_b was 0.855 for the Itx group and 0.730 for the Itx BM group. In conclusion, our findings emphasize the diagnostic and prognostic value of skin biopsy analysis for acute GVHD after Itx.

Reference

Alojz Pleskovič

Abdominal Surgery Department
Medical Center Ljubljana

Zaloška cesta 2

1525 Ljubljana

Slovenija

Email: [email protected]