AJSP2208 - CME/CMLE - Hapatitic Variant of Graft-vs-Host Disease: Prevalence and Comparison With Clinicopathologic Features of the Classic Variant-Hapatitic Variant of Graft-vs-Host Disease: Prevalence and Comparison With Clinicopathologic Features of the Classic Variant

Hapatitic Variant of Graft-vs-Host Disease: Prevalence and Comparison With Clinicopathologic Features of the Classic Variant

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The study focuses on the hepatitic variant of graft-vs-host disease (GVHD) in liver transplant patients, comparing clinicopathologic features and prognostic factors between hepatitic and classic variants. It found that bile duct damage was consistently present in all GVHD cases, with notably more endotheliitis, apoptotic hepatocytes, and ductular reaction in the hepatitic variant. Hepatocyte ballooning was identified as an independent poor prognostic factor associated with a worse outcome. Lobular inflammation was seen in up to 30% of cases without other causes. The study highlighted the importance of integrating histologic findings with clinical context for an accurate GVHD diagnosis. Notably, the time to normalization of liver function tests was longer in the hepatitic variant. The study also analyzed demographic and treatment characteristics between the two variants, revealing differences in liver function test values and response to treatment. The findings suggest that moderate to marked lobular inflammation should not detract from a GVHD diagnosis and that bile duct damage and portal inflammation are key features. Treatment responses varied between the variants, with implications for patient outcomes. The study underscores the significance of liver biopsy in confirming GVHD and excluding other potential causes in transplant patients.

Keywords

hepatitic variant

graft-vs-host disease

liver transplant patients

bile duct damage

endotheliitis

apoptotic hepatocytes

ductular reaction

hepatocyte ballooning

lobular inflammation

liver biopsy