Graft-versus-host disease after orthotopic liver transplantation: A case report and review of the literature

Graft-versus-host disease (GVHD) after liver transplantation (LT) is a rare complication with high mortality and is clinically characterized by fever, skin rash, and diarrhea. The clinical manifestations of GVHD after LT are nonspecific and may resemble viral infection or adverse drug reaction, posing a diagnostic and therapeutic challenge. We report a 60-year-old male who presented with generalized erythematous to violaceous macules and papules accompanied by fever and diarrhea after orthotopic LT. A skin biopsy and human leukocyte antigen typing of peripheral blood confirmed a Grade 2 GVHD. Clinical manifestations and diagnosis of GVHD following LT are discussed. While potentially under-recognized, clinicians should be aware of this rare but potentially fatal complication, as prompt intervention may improve outcomes in LT.