Isolated intestinal manifestation of graft-versus-host disease following renal transplantation

Graft-versus-host disease (GVHD) is a potentially lethal complication commonly occurring after hematopoietic stem cell transplantation and non-irradiated blood cell transfusion in patients with underlying immunodeficiency. In solid organ transplantation GVHD however is a rarity. There have been four cases of GVHD after renal transplantation, most of them with fulminant systemic clinical manifestation and mostly associated with blood transfusions. We report the first case of a four HLA-antigen mismatched kidney transplant patient who presented with diarrhea due to intestine-only manifestation of GVHD and was treated successfully with quadruple immunosuppression.