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Graft-Versus-Host Disease

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Liver Immunology

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Abstract

Successful hematopoietic cell transplantation (HCT) requires engraftment of donor cells to reconstitute hematopoietic and immunologic systems within the host and the ability of donor cells to mediate potent graft-versus-tumor (GVT) alloreactions to eliminate residual tumor cells and prevent relapse mortality. Graft-versus-host disease (GVHD) represents the destructive extension of GVT alloreactions to include inflammatory destruction of nonmalignant host tissues and organs. GVHD is subdivided into acute GVHD (aGVHD) and chronic GVHD (cGVHD), which are distinct clinicopathological syndromes that differ in time of onset, clinical features, therapeutic responses, prognosis, and immunopathogenic mechanisms. aGVHD and cGVHD are the leading causes of morbidity and non-relapse mortality after HCT. GVHD can also occur after solid organ transplantation when donor leukocytes within the allograft engraft in an immunosuppressed allogeneic recipient host. No prophylactic strategies reliably prevent GVHD, and standard therapies for severe GVHD have limited efficacy. Future advances in our understanding of the immunopathogenesis of both aGVHD and cGVHD are required to develop safe and effective strategies for the prevention and treatment of aGVHD and cGVHD.

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Authors and Affiliations

  1. Transplant Hepatology Fellow, Department of Medicine, Baylor College of Medicine, Houston, TX, USA

    Zunirah Ahmed

  2. Departments of Medicine and Surgery, Baylor College of Medicine, Houston, TX, USA

    John M. Vierling

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  1. Zunirah Ahmed
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  2. John M. Vierling
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Correspondence to John M. Vierling .

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Editors and Affiliations

  1. Division of Rheumatology, Allergy and Clinical Immunology, The University of California School of Medicine, Davis, CA, USA

    M. Eric Gershwin

  2. Departments of Medicine and Surgery, Baylor College of Medicine, Houston, TX, USA

    John M. Vierling

  3. Department of Medicine, Teikyo University School of Medicine, Itabashi, Tokyo, Japan

    Atsushi Tanaka

  4. President, Hannover Medical School, Hannover, Germany

    Michael P. Manns

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Ahmed, Z., Vierling, J.M. (2020). Graft-Versus-Host Disease. In: Gershwin, M.E., M. Vierling, J., Tanaka, A., P. Manns, M. (eds) Liver Immunology . Springer, Cham. https://doi.org/10.1007/978-3-030-51709-0_34

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