Acute graft-versus-host disease (aGVHD) is a rare complication after liver transplantation that characterized by high mortality. We presented a case of aGVHD after orthotopic liver transplantation (OLT) for hepatocellular carcinoma (HCC). The patient suffered from fever, oral ulcer, rashes and diarrhea and had a co-infection with Cytomegalovirus (CMV). Short tandem repeat (STR) analysis for cluster of differentiation (CD3) cells and skin biopsy indicated aGVHD. His regimens included high dose of steroids, ruxolitinib, basiliximab, local liver radiotherapy and antibiotics prophylaxis, with the withdrawal of tacrolimus and MMF. Unfortunately, he developed an acute rejection followed by cytomegalovirus infection and lung infection. Soon afterwards he was sent to “isolation ward” due to high suspicion for clinical coronavirus disease 2019 (COVID-19). Fortunately, He was excluded from COVID-19 after nucleic acid and antibody tests. Though closely contact with other COVID-19 patients for a month, the patient was not affected with COVID-19 through his careful protective measures. Finally, the patient recovered after antiviral and antifungal treatment. To our knowledge, this is the first case report of a patient recovered from aGVHD as a close contact.

急性移植物抗宿主病（aGVHD）是肝移植后罕见的并发症，其特点是死亡率高。我们介绍了原位肝移植 (OLT) 治疗肝细胞癌 (HCC) 后发生 aGVHD 的病例。患者出现发烧、口腔溃疡、皮疹和腹泻，并合并感染巨细胞病毒（CMV）。分化簇 (CD3) 细胞和皮肤活检的短串联重复 (STR) 分析表明存在 aGVHD。他的治疗方案包括高剂量类固醇、ruxolitinib、巴利昔单抗、局部肝脏放疗和抗生素预防，同时停用他克莫司和 MMF。不幸的是，他发生了急性排斥反应，随后发生了巨细胞病毒感染和肺部感染。不久之后，由于高度怀疑临床冠状病毒病 2019 (COVID-19)，他被送往“隔离病房”。幸运的是，经过核酸和抗体检测，他被排除在 COVID-19 之外。尽管与其他 COVID-19 患者密切接触了一个月，但患者通过精心的防护措施并未感染 COVID-19。最后，患者经抗病毒、抗真菌治疗后痊愈。据我们所知，这是首例 aGVHD 康复患者作为密切接触者的病例报告。