CASE REPORT article
Front. Transplant.
Sec. Transplantation Immunology
Volume 4 - 2025 | doi: 10.3389/frtra.2025.1682433
Case Report: Successful Treatment of Steroid-Refractory Graft-Versus-Host Disease Following Bilateral Lung Transplantation
Provisionally accepted
- The University of Alabama at Birmingham, Birmingham, United States
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Graft-versus-host disease (GVHD) is a rare but potentially fatal complication following solid organ transplantation (SOT), with limited reported cases and high mortality rates after lung transplantation. We present a case of steroid-refractory GVHD (SR-GVHD) following bilateral lung transplantation and review the literature on GVHD in SOT. A patient developed SR-GVHD affecting the skin, gut, liver, and bone marrow following bilateral lung transplantation. Initial treatment with high-dose corticosteroids was ineffective. Subsequent therapy with rabbit anti-thymocyte globulin (rATG) and ruxolitinib led to complete remission over two months. Short tandem repeat (STR) analysis aided in diagnosis and monitoring. This case highlights the importance of early diagnosis and aggressive treatment of GVHD following SOT. We propose a treatment algorithm including rapid escalation to multi-agent immunosuppression for SR-GVHD. Interdisciplinary collaboration between solid organ and stem cell transplant specialists is crucial. Further research is needed to identify optimal strategies for prevention and treatment of GVHD in SOT recipients.
Keywords: Graft Versus Host Desease, Lung tranplant, Transplant related complications, Solid organ transplant (SOP), Immunosuppression
Received: 08 Aug 2025; Accepted: 29 Sep 2025.
Copyright: © 2025 McCormick, Rusanov, Tao, Kaleekal, Wille and Espinoza-Gutarra. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Benjamin J McCormick, bjmccormick@uabmc.edu
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