Diagnosis and differential diagnosis of hepatic graft versus host disease (GVHD)

Karen E. Matsukuma, Dongguang Wei, Kai Sun, Rajendra Ramsamooj, Mingyi Chen

Research output: Contribution to journalReview articlepeer-review

37 Scopus citations


Graft versus host disease (GVHD) is a common complication following allogeneic hematopoietic cell transplantation (HCT) that typically manifests as injury to the skin, gastrointestinal mucosa, and liver. In some cases, hepatic GVHD may be histologically indistinguishable from other disorders such as infection and drug-induced liver injury (DILI). Additionally, clinical signs and symptoms are frequently confounded by the superimposed effects of pretransplant chemoradiotherapy, immunotherapy (IT) (targeted to the underlying malignancy), GVHD prophylaxis, and infection. Thus, careful attention to and correlation with clinical findings, laboratory values, and histologic features is essential for diagnosis. This review, aimed at the practicing pathologist, will discuss current clinical and histologic criteria for GVHD, the approach to diagnosis of hepatic GVHD, and features helpful for distinguishing it from other entities in the differential diagnosis.

Original languageEnglish (US)
Pages (from-to)S21-S31
JournalJournal of Gastrointestinal Oncology
StatePublished - Apr 1 2016


  • Drug-induced liver injury (DILI)
  • Graft versus host disease (GVHD)
  • Hematopoietic cell transplantation (HCT)
  • Hepatic lymphoma
  • Immunotherapy (IT)
  • Post-transplant lymphoproliferative disorder (PTLD)
  • Veno-occlusive hepatic disease

ASJC Scopus subject areas

  • Oncology
  • Gastroenterology


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