[Post-transfusional syndrome like graft versus host disease].
We studied clinical and immunological changes of the post-transfusional syndrome like graft versus host disease (GVDH) in six patients after open heart surgery and in one patient after hepatectomy. In the patient with hepatocellular carcinoma, transcatheter arterial embolization had been previously done. All patients received homologous blood transfusion during and after surgery and erythroderma associated hyperthermia occurred approximately 10 days after operation. Patients receiving open heart surgery died on between postoperative 17th and 21st day. One patient with hepatectomy died on the 29th day after operation. Skin biopsies in all patients showed the findings of acute GVHD. The number of CD3+ and CD4+ T lymphocytes decreased at postoperative day 1, however, the number of CD3+ T lymphocyte increased in three patients after postoperative day 14. The postoperative value of interleukin-2 production was low in patients in whom the value was measured. The immunological status in host has not been clearly resolved. However, the postoperative changes of lymphocytes subsets were abnormal and IL-2 production in two patients showed low level. Therefore, it was considered that pre and postoperative measurement of cell-modiated immunity might predict the occurrence of the post-transfusional GVHD and might be one of useful examinations to prevent the disease.
Second Department of Surgery, Kurume University School of Medicine, Japan.
K
K
Hisatomi
A
A
Hirano
K
K
Okuda
T
T
Isomura
S
S
Aoyagi
K
K
Kosuga
K
K
Oishi
D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000276:immunology / Q000601:surgery; D005112:Extracorporeal Circulation; D006086:Graft vs Host Disease / Q000209:etiology* / Q000517:prevention & control; D006498:Hepatectomy; D006801:Humans; D007111:Immunity, Cellular; D007376:Interleukin-2 / Q000096:biosynthesis; D008113:Liver Neoplasms / Q000276:immunology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000276:immunology / Q000601:surgery; D016176:T-Lymphocyte Subsets; D065227:Transfusion Reaction
D007376:Interleukin-2