Transfusion Associated Graft Versus Host Disease: A Case Report and Review of Literature

Divya Doval,Tina Dadu,Dharma Choudhary,Vipin Khandelwal,Sanjeev K Sharma,Meet Kumar,Anil Handoo

doi:10.11648/j.ijcems.20190503.11

Abstract

Transfusion associated graft versus host disease (TA-GvHD) is a rare but usually fatal complication of transfusion of cellular blood products. It is seen usually in immunosuppressed individuals due to engraftment of viable T lymphocytes but it may also occur in immunocompetent individuals. Patients present with fever, skin rash, diarrhoea, hepatic dysfunction and bone marrow aplasia which manifests as pancytopenia. The diagnosis of TA-GvHD is often delayed because of lack of awareness due to the non-specific manifestations and often these symptoms are attributed to the underlying illness. We present here a case report of fatal TA-GvHD in an immunocompetent patient, post coronary artery bypass grafting surgery after transfusion of blood products. The patient died 27 days after a blood transfusion. An increased risk of TA-GvHD following bypass grafting and other surgical procedures where cardiopulmonary bypass is required has been perceived. TA-GvHD is under reported and the incidence is felt to be too low to warrant routine irradiation of cellular products. Physicians, surgeons and transfusion centers should be aware of this rare but devastating complication of blood transfusion so as to either diagnose it early or rather prevent it.

Highlights

IntroductionTransfusion associated graft versus host disease (TA-GvHD) is a rare but usually fatal complication of transfusion of cellular blood products. [1, 2] It was first reported in 1955
Transfusion associated graft versus host disease (TA-GvHD) is a rare but usually fatal complication of transfusion of cellular blood products. [1, 2] It was first reported in 1955. It is seen usually in immunosuppressed individuals but it may occur in immunocompetent individuals The diagnosis of TA-GvHD is often delayed because of lack of awareness due to the non-specific manifestations and often these symptoms are attributed to the underlying illness
Unlike GvHD associated with hematopoietic cell transplantation (HCT), TA-GvHD mainly affects the recipient's bone marrow and is almost always fatal.[3]

Summary

Introduction

Transfusion associated graft versus host disease (TA-GvHD) is a rare but usually fatal complication of transfusion of cellular blood products. [1, 2] It was first reported in 1955. [1, 2] It was first reported in 1955. Transfusion associated graft versus host disease (TA-GvHD) is a rare but usually fatal complication of transfusion of cellular blood products. It is seen usually in immunosuppressed individuals but it may occur in immunocompetent individuals The diagnosis of TA-GvHD is often delayed because of lack of awareness due to the non-specific manifestations and often these symptoms are attributed to the underlying illness. An increased risk of TA-GvHD following bypass grafting where cardiopulmonary bypass is required has been reported. An increased risk of TA-GvHD following bypass grafting where cardiopulmonary bypass is required has been reported. [6]

Case Report

Discussion

Findings

Conclusion