Abstract
Transfusion-associated graft-vs-host disease (GvHD) is a very rare complication of blood transfusion; there are no identifiable cases in the most recent SHOT report. This reduction in incidence has resulted from the implementation of universal leucodepletion. GvHD can complicate allogenic bone marrow transplants, but in those who are immunocompromised, it can occur after simple blood transfusion. Ninety per cent of cases are fatal. Donor derived immune cells, particularly T-lymphocytes, mount an immune response against host tissue. Clinical features include a maculopapular rash (typically affecting the face, palms and soles), abdominal pain, diarrhoea and abnormal liver function tests. Destruction of bone marrow stem cells by donor T-lymphocytes causes pancytopenia. Prevention is by irradiation of blood products, which inactivates any donor lymphocytes.4
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