Transfusion associated graft versus host disease (TA-GvHD) is a rare but usually fatal complication of transfusion of cellular blood products. It is seen usually in immunosuppressed individuals due to engraftment of viable T lymphocytes but it may also occur in immunocompetent individuals. Patients present with fever, skin rash, diarrhoea, hepatic dysfunction and bone marrow aplasia which manifests as pancytopenia. The diagnosis of TA-GvHD is often delayed because of lack of awareness due to the non-specific manifestations and often these symptoms are attributed to the underlying illness. We present here a case report of fatal TA-GvHD in an immunocompetent patient, post coronary artery bypass grafting surgery after transfusion of blood products. The patient died 27 days after a blood transfusion. An increased risk of TA-GvHD following bypass grafting and other surgical procedures where cardiopulmonary bypass is required has been perceived. TA-GvHD is under reported and the incidence is felt to be too low to warrant routine irradiation of cellular products. Physicians, surgeons and transfusion centers should be aware of this rare but devastating complication of blood transfusion so as to either diagnose it early or rather prevent it.
| Published in | International Journal of Clinical and Experimental Medical Sciences (Volume 5, Issue 3) |
| DOI | 10.11648/j.ijcems.20190503.11 |
| Page(s) | 46-48 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2019. Published by Science Publishing Group |
Transfusion Associated GvHD (TA-GvHD), Immunocompetent Host, Post CABG
| [1] | Williamson LM, Warwick RM,: Transfusion-associated graft-versus-host disease and its prevention. Blood Reviews9, 1995, 251–261. |
| [2] | Brubaker DB: Transfusion-associated graft-versus-host disease. Hum Pathol, 1986, 17: 1085-1088. |
| [3] | Nishimura M, Uchida S, Mitsunaga S,: Characterization of T-cell clones derived from peripheral blood lymphocytes of a patient with transfusion-associated graft-versus-host disease: Fas-mediated killing by CD4 + and CD8 + cytotoxic T-cell clones and tumor necrosis factor beta production by CD4 + T-cell clones. Blood, 1997, 89: 1440-1445. |
| [4] | Mori S., Matsushita H., Ozaki K., et al: Spontaneous resolution of transfusion-associated graft-versus-host disease. Transfusion 1995, 35: pp. 431-435. |
| [5] | Hutchinson K., Kopko P. M., Muto K. N., et al: Early diagnosis and successful treatment of a patient with transfusion-associated GvHD with autologous peripheral blood progenitor cell transplantation. Transfusion 2002; 42: pp. 1567-2572. |
| [6] | Ahyaa R, Douglasb JG, Watsonc HG: Transfusion associated graft versus host disease in an immunocompetent individual following coronary artery bypass grafting. Heart 1998; 80: 299–300. |
| [7] | Ferrara JL, Deeg HJ.: Graft-versus-host disease. N Engl J Med, 1991, 324: 667. |
| [8] | Sakakibara T, Juji T.: Post-transfusion graft-versus-host disease after open heart surgery. Lancet, 1986, 2: 1099. |
| [9] | Shivdasani RA, Haluska FG, Dock NL. Brief report: graft-versus-host disease associated with transfusion of blood from unrelated HLA-homozygous donors. N Engl J Med, 1993328: 766. |
| [10] | Kopolovic I, Ostro J, Tsubota H, et al.: A systematic review of transfusion-associated graft-versus-host disease. Blood, 2015, 126: 406. |
| [11] | Ferrara J. L., and Reddy P.: Pathophysiology of graft-versus-host disease. Semin Hematol 2006; 43: pp. 3-10. |
| [12] | Aoun E, Shamseddine A, Chehal A.: Transfusion-associated GVHD: 10 years' experience at the American University of Beirut-Medical Center. Transfusion, 2003 43: 1672. |
| [13] | Schroeder ML.: Transfusion-associated graft-versus-host disease. Br J Haematol, 2002117: 275. |
| [14] | Takahashi K, Juji T, Miyazaki H: Post transfusion graft versus host disease occurring in non immunosuppressed patients in Japan. Transfus Sci, 1991, 12: 281–289. |
| [15] | Juji T, Takahashi K, Shibata Y, et al.: Post-transfusion graft versus-host disease in immunocompetent patients after cardiac surgery in Japan. N Engl J Med, 1989, 321: 56. |
| [16] | Dwyre DM, Holland PV. Transfusion-associated graft-versus-host disease, Vox Sanguinis, 2008, 95, 85–93. |
| [17] | Thaler M., Shamiss A., Orgad S., et al: The role of blood from HLA-homozygous donors in fatal transfusion-associated graft-versus-host disease after open-heart surgery. N Engl J Med 1989; 321: pp. 25-28. |
| [18] | Aybey B., Coskun D., and Aytac J.: Transfusion associated graft versus host disease following cardiovascular surgery. Mikrobiyol Bul 2006; 40: pp. 103-107. |
| [19] | Loren D Fast, Preventing transfusion-associated graft-versus-host disease: state of the art International Journal of Clinical Transfusion Medicine 2015: 2. |
APA Style
Divya Doval, Sanjeev K. Sharma, Meet Kumar, Vipin Khandelwal, Anil Handoo, et al. (2019). Transfusion Associated Graft Versus Host Disease: A Case Report and Review of Literature. International Journal of Clinical and Experimental Medical Sciences, 5(3), 46-48. https://doi.org/10.11648/j.ijcems.20190503.11
ACS Style
Divya Doval; Sanjeev K. Sharma; Meet Kumar; Vipin Khandelwal; Anil Handoo, et al. Transfusion Associated Graft Versus Host Disease: A Case Report and Review of Literature. Int. J. Clin. Exp. Med. Sci. 2019, 5(3), 46-48. doi: 10.11648/j.ijcems.20190503.11
AMA Style
Divya Doval, Sanjeev K. Sharma, Meet Kumar, Vipin Khandelwal, Anil Handoo, et al. Transfusion Associated Graft Versus Host Disease: A Case Report and Review of Literature. Int J Clin Exp Med Sci. 2019;5(3):46-48. doi: 10.11648/j.ijcems.20190503.11
Share This Article
Twitter
Linked In
Facebook
Copy
Download@article{10.11648/j.ijcems.20190503.11,
author = {Divya Doval and Sanjeev K. Sharma and Meet Kumar and Vipin Khandelwal and Anil Handoo and Tina Dadu and Dharma Choudhary},
title = {Transfusion Associated Graft Versus Host Disease: A Case Report and Review of Literature},
journal = {International Journal of Clinical and Experimental Medical Sciences},
volume = {5},
number = {3},
pages = {46-48},
doi = {10.11648/j.ijcems.20190503.11},
url = {https://doi.org/10.11648/j.ijcems.20190503.11},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcems.20190503.11},
abstract = {Transfusion associated graft versus host disease (TA-GvHD) is a rare but usually fatal complication of transfusion of cellular blood products. It is seen usually in immunosuppressed individuals due to engraftment of viable T lymphocytes but it may also occur in immunocompetent individuals. Patients present with fever, skin rash, diarrhoea, hepatic dysfunction and bone marrow aplasia which manifests as pancytopenia. The diagnosis of TA-GvHD is often delayed because of lack of awareness due to the non-specific manifestations and often these symptoms are attributed to the underlying illness. We present here a case report of fatal TA-GvHD in an immunocompetent patient, post coronary artery bypass grafting surgery after transfusion of blood products. The patient died 27 days after a blood transfusion. An increased risk of TA-GvHD following bypass grafting and other surgical procedures where cardiopulmonary bypass is required has been perceived. TA-GvHD is under reported and the incidence is felt to be too low to warrant routine irradiation of cellular products. Physicians, surgeons and transfusion centers should be aware of this rare but devastating complication of blood transfusion so as to either diagnose it early or rather prevent it.},
year = {2019}
}
TY - JOUR T1 - Transfusion Associated Graft Versus Host Disease: A Case Report and Review of Literature AU - Divya Doval AU - Sanjeev K. Sharma AU - Meet Kumar AU - Vipin Khandelwal AU - Anil Handoo AU - Tina Dadu AU - Dharma Choudhary Y1 - 2019/08/07 PY - 2019 N1 - https://doi.org/10.11648/j.ijcems.20190503.11 DO - 10.11648/j.ijcems.20190503.11 T2 - International Journal of Clinical and Experimental Medical Sciences JF - International Journal of Clinical and Experimental Medical Sciences JO - International Journal of Clinical and Experimental Medical Sciences SP - 46 EP - 48 PB - Science Publishing Group SN - 2469-8032 UR - https://doi.org/10.11648/j.ijcems.20190503.11 AB - Transfusion associated graft versus host disease (TA-GvHD) is a rare but usually fatal complication of transfusion of cellular blood products. It is seen usually in immunosuppressed individuals due to engraftment of viable T lymphocytes but it may also occur in immunocompetent individuals. Patients present with fever, skin rash, diarrhoea, hepatic dysfunction and bone marrow aplasia which manifests as pancytopenia. The diagnosis of TA-GvHD is often delayed because of lack of awareness due to the non-specific manifestations and often these symptoms are attributed to the underlying illness. We present here a case report of fatal TA-GvHD in an immunocompetent patient, post coronary artery bypass grafting surgery after transfusion of blood products. The patient died 27 days after a blood transfusion. An increased risk of TA-GvHD following bypass grafting and other surgical procedures where cardiopulmonary bypass is required has been perceived. TA-GvHD is under reported and the incidence is felt to be too low to warrant routine irradiation of cellular products. Physicians, surgeons and transfusion centers should be aware of this rare but devastating complication of blood transfusion so as to either diagnose it early or rather prevent it. VL - 5 IS - 3 ER -
Information
Email: