Transfusion-associated graft-versus-host disease and its prevention.
Transfusion-associated graft-versus-host disease is a rare but usually fatal complication of transfusion of cellular blood components, caused by multiorgan engraftment and proliferation of donor T lymphocytes. The classical features of skin rash, diarrhoea and hepatitis, along with striking bone-marrow failure, are seen 1-2 weeks after transfusion. Although early reports described the condition only in immunosuppressed individuals, sharing of an HLA haplotype between donor and an immunocompetent recipient can also result in transfusion-associated graft-versus-host disease. The condition is entirely preventable by gamma irradiation of cellular blood components to 25 Gy, although this results in some reduction of red-cell viability and increased loss of red-cell potassium. The major indications for irradiated blood components include bone marrow/stem cell auto- or allografting, Hodgkin's disease, intrauterine transfusions, and transfusions from relatives or HLA-selected platelet donors.
Williamson
L M
LM
Division of Transfusion Medicine, University of Cambridge and East Anglian Blood Centre, UK.
Warwick
R M
RM
D001782:Blood Donors; D004912:Erythrocytes / Q000528:radiation effects; D005260:Female; D005720:Gamma Rays; D006086:Graft vs Host Disease / Q000175:diagnosis / Q000276:immunology* / Q000628:therapy; D006680:HLA Antigens / Q000097:blood* / Q000235:genetics; D006239:Haplotypes; D006801:Humans; D007231:Infant, Newborn; D008214:Lymphocytes / Q000528:radiation effects; D011247:Pregnancy; D065227:Transfusion Reaction
D006680:HLA Antigens