Medicine & USMLE

Graft vs Host Disease (GVHD)

Transplant Rejection
  1. Hyperacute Transplant Rejection
  2. Acute Transplant Rejection
  3. Chronic Transplant Rejection
  4. Graft vs Host Disease (GVHD)


Graft vs. Host Disease (GVHD) is a pathology that can occur after organ transplant. GVHD occurs when donor or grafted T-cells attack the cells of an immunocompromised host, causing widespread or systemic damage. GVHD is commonly seen after bone marrow and liver transplants, since these transplanted organs contain a high number of T-lymphocytes. 

Key Points

  • Graft vs. Host Disease (GVHD
    • Variable onset after transplantation / transfusion
    • Donor T cells in graft / transfusion attack an immunocompromised recipient
      • Host immune system unable to kill foreign T-cells, since immunosuppression is necessary for transplant rejection prophylaxis
      • Example of Type IV Hypersensitivity Reaction
    • Usually seen in bone marrow and liver transplants
      • These organs are rich in T-lymphocytes
    • Widespread / systemic symptoms (since donor T cells migrate into host)
      • Maculopapular rash (skin)
      • Diarrhea and abdominal pain (GI tract)
      • Jaundice and hepatosplenomegaly (liver)
    • May be beneficial in cancer patients, due to graft vs. tumor effect
      • Donor T cells may attack host tumor cells
    • Can be prevented by irradiation of blood products / organs prior to transfusion / transplant
      • Kills T-lymphocytes, but can also damage other cells