Graft-versus-host disease (GVHD) is a rare, potentially life-threatening complication that can happen after an organ transplant. It occurs when the donor’s immune cells attack the recipient’s body, leading to symptoms such as nausea, skin rash, loss of appetite, diarrhea, abdominal cramps, and jaundice (yellowing of the skin or the whites of the eyes).
At UPMC, our experts will carefully monitor your condition after your transplant and watch for early signs of complications. If you are diagnosed with GVHD, our team follows evidence-based treatment protocols to give you the best chance of a successful outcome.
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Graft-versus-host disease (GVHD) is a rare, potentially life-threatening complication that occurs after an organ transplant. It occurs when the organ donor’s immune cells attack the recipient’s body.
There are two types of GVHD, including:
Acute GVHD has four stages, also called grades, including:
Chronic GVHD is typically staged as mild, moderate, or severe based on the number of organs involved.
GVHD is a rare condition, and rates vary depending on the type of organ transplant:
GVHD occurs in up to:
GVHD is very rare after lung and kidney transplants.
GVHD occurs when the organ donor’s immune cells recognize the recipient’s body as foreign and begin to attack parts of the recipient’s body.
Before an organ transplant, you and your organ donor will go through extensive testing to find out if your donor’s tissue and cells are a close enough match to yours. A close match is required to safely proceed with an organ transplant. However, only identical twins will be a perfect match.
The closer the donor/recipient match, the lower the risk of GVHD. If GVHD does occur, symptoms will likely be milder when the donor/recipient match is close. You may be at higher risk for GVHD — or at higher risk for developing more severe GVHD — if you are not a close match for your organ donor.
GHVD itself can cause serious complications if left untreated, including life-threatening organ damage.
Treatment for GVHD may weaken your immune system and increase your risk of developing life-threatening infections.
There is nothing you can do to prevent GVHD. However, your transplant team will take steps to reduce your risk by selecting a closely matched donor organ and carefully monitoring your condition after your transplant. Early GVHD diagnosis can increase the chances of successful treatment.
Symptoms of acute and chronic GVHD may vary and differ from person to person. Common symptoms include:
Acute GVHD symptoms may affect your skin or gastrointestinal tract. They typically start within six months of a transplant and may include:
Chronic GVHD symptoms typically start three months or more after a transplant and can be lifelong.
Chronic GVHD symptoms may include:
If you have symptoms of GVHD, you should schedule an appointment with your doctor right away. Early diagnosis can improve your chances of successful treatment.
Your doctor will perform a physical exam and order tests to help diagnose GVHD.
If your doctor suspects GVHD, they will:
Tests to diagnose GVHD may include:
Blood tests to diagnose GVHD may include:
Imaging tests to diagnose GVHD may include:
A biopsy is a procedure that involves using a thin needle to remove tissue samples from your organs. The tissue samples are examined in the lab for signs of GVHD or other complications.
People who have an organ transplant need to take immunosuppressant medications for the rest of their lives. GVHD can often be treated with adjustments to your immunosuppressant medications. However, these adjustments must be carefully managed because they may weaken your immune system and increase your risk of developing a life-threatening infection.
Survival rates for GVHD depend on whether the condition is acute or chronic, as well as the stage, your overall health, and other factors. Your doctor will discuss your expected survival rate with you.
GVHD treatment involves increasing the dose of immunosuppressant medications to control symptoms. Treatment options may include:
Your doctor may increase your dose of corticosteroids, which may be taken by mouth (oral), applied to your skin (topical), or given through a vein (intravenous). If corticosteroids aren’t enough to control your symptoms, your doctor may prescribe other medications.
Corticosteroid medications may not be effective for controlling symptoms of chronic GVHD, so your doctor may prescribe other medications to suppress your immune response.
In severe cases of chronic GVHD, your doctor may recommend photopheresis. Photopheresis is a type of immunotherapy that involves using a machine to separate white blood cells called lymphocytes from the rest of your blood. The machine uses ultraviolet light to change how lymphocytes work, slowing or stopping the immune reaction that causes GVHD symptoms.
You may be eligible to enroll in a clinical trial to study preventive therapies or treatments for acute or chronic GVHD. Your doctor will let you know if you may be eligible for a clinical trial.
When you choose UPMC for GVHD care, you will receive:
By UPMC Editorial Staff. Last reviewed on 2025-12-09.
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