DONOR-DERIVED LONG-TERM MULTILINEAGE HEMATOPOIESIS IN A LIVER-TRANSPLANT RECIPIENT

GRAFT-VERSUS-HOST disease (GVHD) has been well documented in several recipients of liver transplants.1-8 In this syndrome alloreactive cells from the donor attack the recipient's skin, gastrointestinal tissue, and hematopoietic tissue. Severe myelosuppression commonly results, but there has been a degree of recovery of hematopoiesis in some patients after immunosuppressive therapy. The recovery of hematopoiesis resulted from the recovery of the recipient's bone marrow in some cases,1,3 but it also could be due to the proliferation of hematopoietic precursor cells in the donor's liver, since the liver is a site of hematopoiesis in fetuses and, under certain circumstances, in adults. We investigated this possibility in a liver-transplant recipient in whom hematopoiesis recovered after treatment of GVHD. We found that the hematopoiesis in our patient derived from stem cells present in the donor's liver.