Graft-versus-host disease in paediatric liver transplantation: A review of the literature

Background. Graft versus host disease (GvHD) is a major complication after haematopoietic stem-cell transplantation but much less common after solid organ transplant and rare after liver transplantation. Early symptoms can resemble viral infections or drug-reactions and thus it may be under-investigated. There are no standard treatment guidelines for GvHD after paediatric liver transplantation.Objectives. To review all cases of GvHD reported to date after paediatric liver transplant.Methods. Literature review of all English-language full-text articles published between 1990 and 2017Results. Case series articles and case reports were reviewed and collated. Symptoms, diagnostic investigations, treatments and outcomes were described for all reported cases.Conclusion. GvHD in paediatric liver transplantation is difficult to treat and has a high mortality, but better recognition and understanding with novel therapies available offer hope for the future