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Transfusion-associated graft versus host disease

transfusion-associated graft versus host disease pictures, transfusion-associated graft versus host disease treatment
Transfusion-associated graft-versus-host disease TA-GvHD is a rare complication of blood transfusion, in which the donor T lymphocytes mount an immune response against the recipient's lymphoid tissue1 Donor lymphocytes are usually identified as foreign and destroyed by the recipient's immune system However, in situations where the recipient is immunocompromised inborn immunodeficiency, acquired immunodeficiency, malignancy, or when the donor is homozygous and the recipient is heterozygous for an HLA haplotype as can occur in directed donations from first-degree relatives, the recipient's immune system is not able to destroy the donor lymphocytes This can result in graft-versus-host disease

Contents

  • 1 Epidemiology and pathogenesis
  • 2 Presentation and diagnosis
    • 21 Clinical manifestations
    • 22 Laboratory manifestations
    • 23 Diagnosis
  • 3 Treatment and prevention
  • 4 References

Epidemiology and pathogenesisedit

The incidence of TA-GvHD in immunocompromised patients receiving blood transfusions is estimated to be 01 - 10%, and mortality around 80 - 90% Mortality is higher in TA-GvHD than in GvHD associated with bone marrow transplantation, where the engrafted lymphoid cells in the bone marrow are of donor origin and therefore the immune reaction is not directed against them

The most common causes of death in TA-GvHD are infections and hemorrhages secondary to pancytopenia and liver dysfunction

Presentation and diagnosisedit

Clinical manifestationsedit

The clinical presentation is the same as GvHD occurring in other settings, such as bone marrow transplantation TA-GvHD can develop four to thirty days after the transfusion Typical symptoms include:

  • fever
  • erythematous maculopapular rash, which can progress to generalised erythroderma
  • toxic epidermal necrolysis in extreme cases

Other symptoms can include cough, abdominal pain, vomiting, and profuse diarrhea up to 8 liters/day

Laboratory manifestationsedit

Laboratory findings include pancytopenia, abnormal liver enzymes, and electrolyte imbalance when diarrhea is present

Diagnosisedit

TA-GvHD can be suspected from a biopsy of the affected skin, and established by HLA analysis of the circulating lymphocytes This testing can identify circulating lymphocytes with a different HLA type than the tissue cells of the host

Treatment and preventionedit

Treatment is only supportive, as no available form of therapy has proven effective in treating TA-GvHD

Prevention includes gamma irradiation of the lymphocyte-containing blood products This procedure should be performed in transfusions when:

  • The recipient is immunocompromised
  • The blood components are from a family donor
  • HLA-matched platelets are transferred

Another means of prevention is the use of third- or fourth-generation leukoreduction filters, although the efficacy of this procedure has not yet been documented

Referencesedit

  1. ^ "Complications of Transfusion: Transfusion Medicine: Merck Manual Professional" Retrieved 2009-02-09 
  • Anwar M, Bhatti F 2003 "Transfusion associated graft versus host disease" J Ayub Med Coll Abbottabad 15 3: 56–8 PMID 14727344  Full text
  • Gupta, A; Bansal, D; Dass, R; Das, A 2004 "Transfusion Associated Graft versus Host Disease" Indian Pediatr 41 12: 1260–1264 PMID 15623910  Full text PDF
  • Darrell J Triulzi: Transfusion associated graft vs host disease and irradiated blood components
  • Eric Kardon, eMedicine: Transfusion Reactions

transfusion-associated graft versus host disease definition, transfusion-associated graft versus host disease pictures, transfusion-associated graft versus host disease skin, transfusion-associated graft versus host disease treatment


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Transfusion-associated graft versus host disease


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    Transfusion-associated graft versus host disease beatiful post thanks!

    29.10.2014


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