Transfusion‐associated graft‐versus‐host disease in immunocompetent patients: case series and review of the literature

Abstract

TA-GVHD is probably more prevalent than reported in the literature. It must be considered in the differential diagnosis, if the patient with a recent transfusion history admits with fever, skin rash, abnormal liver function tests, and pancytopenia associated with hypoplastic marrow. In rural areas where gamma irradiation is not possible, the overall policy of transfusion (e.g., restriction of transfusion indications and alternative methods for pathogen inactivation) should be reassessed.

Pathology of graft-versus-host disease in the gastrointestinal tract

“…The transfused T cells can then engraft and mount an immunologic attack against the recipient's unshared haplotype instead of being rejected as would normally occur. In transfusion-associated GVHD, the recipient marrow is the major target, resulting in refractory pancytopenia that is often fatal [17]. Skin, GI tract, and liver are also affected.…”

Transfusion-Associated Microchimerism in Combat Casualties

“…40,41 TA-GVHD is extremely rare and most commonly occurs in immunodeficient patients, although isolated reports of TA-GVHD in immunocompetent patients have been documented. [42][43][44] In summary, these preliminary data do not demonstrate a significantly increased rate of TA-MC in recipients of FrWB or plts compared with RBCs. Larger studies are needed to determine whether there is an increased rate of TA-MC in combat casualties transfused with FrWB.…”

Passenger lymphocyte syndrome in ABO and Rhesus D minor mismatched liver and kidney transplantation: A prospective analysis

“…HLA sharing promotes lymphocyte engraftment in transfusion associated GVHD and microchimerism [32,33], nonetheless, it may not be necessary to facilitate PLS in RT patients. Kidney donor-recipient pairs were HLA mismatched and PLS occurred in 2 patients despite the presence of HLA disparity between donors and recipients.…”