Transfusion associated graft versus host disease in an immunocompetent individual following coronary artery bypass grafting

Transfusion associated graft versus host disease (TA-GVHD) is a rare but commonly fatal complication of transfusion of cellular blood products, which usually occurs in immunosuppressed individuals following transfusion and subsequent engraftment of viable T lymphocytes. Very rarely it may arise in a...

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Bibliographic Details
Published in:	Heart (British Cardiac Society) 1998-09, Vol.80 (3), p.299-300
Main Authors:	Ahya, R, Douglas, J G, Watson, H G
Format:	Article
Language:	eng
Subjects:	Biological and medical sciences Biopsy Blood products blood transfusion Blood transfusions Bone marrow Case Report Coronary Artery Bypass coronary artery bypass graft Coronary vessels graft versus host disease Graft vs Host Disease - etiology Haplotypes Heart surgery Hepatitis Histocompatibility Testing Humans Immunocompetence Lymphocytes Male Medical sciences Middle Aged Postoperative Complications - immunology Skin Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the heart Transfusion Reaction
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Summary:	Transfusion associated graft versus host disease (TA-GVHD) is a rare but commonly fatal complication of transfusion of cellular blood products, which usually occurs in immunosuppressed individuals following transfusion and subsequent engraftment of viable T lymphocytes. Very rarely it may arise in apparently immunocompetent individuals. A case is reported of TA-GVHD in a non-immunocompromised 60 year old white man, resulting from red cell transfusion after coronary artery bypass grafting. HLA typing confirmed homozygosity of the donor for an HLA type shared by the recipient—the classic scenario for the development of TA-GVHD in immunocompetent individuals. The patient died 21 days after transfusion. There is a perceived increased risk of TA-GVHD following bypass grafting and other surgical procedures where cardiopulmonary bypass is required. TA-GVHD is probably underreported and the incidence in the UK is felt to be too low to warrant routine irradiation of cellular products for this group of patients. Clinicians, pathologists, and transfusion centres should be aware of this rare but devastating complication of blood transfusion after cardiac surgery.
ISSN:	1355-6037 1468-201X