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Graft-versus-host disease from leukocyte transfusions
Journal of the American Academy of Dermatology
|September 1, 1983
Summary
Transfusion of immunocompetent lymphocytes can cause fatal graft-versus-host disease (GVHD) in immunosuppressed patients. Irradiating blood products before transfusion is a critical preventive measure against this severe complication.
Area of Science:
- Immunology
- Transfusion Medicine
- Oncology
Background:
- Immunocompetent lymphocytes in transfused blood products pose a risk for graft-versus-host disease (GVHD) in immunosuppressed recipients.
- Renal transplant patients are particularly vulnerable due to their compromised immune status.
Observation:
- A 30-year-old renal transplant patient developed fatal GVHD two weeks post-transfusion.
- The patient received 1.0 x 10^8 lymphocytes/kilogram.
- Clinical manifestations included typical cutaneous and gastrointestinal symptoms, alongside irreversible bone marrow failure.
Findings:
- Acute GVHD following transfusion from normal donors carries an 88% mortality rate.
- The described case highlights the severe and potentially lethal consequences of lymphocyte transfusion in transplant recipients.
Implications:
- Current treatments for GVHD are largely unsatisfactory.
- Irradiation of blood products before transfusion is a crucial preventive strategy.
- This underscores the importance of implementing pathogen reduction techniques in transfusion medicine.