Transfusion-associated graft-versus-host disease
Rare transfusion complication with high mortality from donor lymphocyte engraftment.
Transfusion-associated graft-versus-host disease (TA-GvHD) is a rare complication of blood transfusion in which immunologically competent donor T lymphocytes engraft and mount an immune response against the recipient's lymphoid tissue. It occurs when the recipient is severely immunocompromised or when donor and recipient HLA types are similar, as can happen with directed donations from first-degree relatives. This contrasts with organ or tissue transplant-associated GvHD, where matching HLA reduces the incidence of the complication.
Quick Facts
- Field
- Hematology
Facts from the source article.
Did You Know?
- Laboratory findings include pancytopenia, marrow aplasia, abnormal liver enzymes, and electrolyte imbalance when diarrhea is present.
- TA-GvHD can be suspected from a biopsy of the affected skin or liver, and established by HLA analysis of circulating lymphocytes.
- In 2023, the first case of fetal-induced GvHD was reported in the New England Journal of Medicine.
Epidemiology
For immunocompromised transfusion recipients, the condition occurs in about 0.1 to 1.0 percent of cases, with a fatality rate near 80 to 90 percent. This form is deadlier than graft-versus-host disease from bone marrow transplants, where donor immune cells are not attacked because they are the same as the recipient's own. Death typically results from infections or bleeding caused by low blood cell counts and liver failure.
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