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[Post-transfusional syndrome like graft versus host disease]
K Hisatomi1, A Hirano, K Okuda
1Second Department of Surgery, Kurume University School of Medicine, Japan.
Nihon Geka Gakkai Zasshi
|April 1, 1993
Summary
Post-transfusional graft-versus-host disease (GVHD) occurred in surgical patients receiving blood transfusions, leading to fatal outcomes. Monitoring cell-mediated immunity may help predict and prevent this serious complication.
Area of Science:
- Immunology
- Transfusion Medicine
- Surgical Oncology
Background:
- Investigated clinical and immunological changes in post-transfusional graft-versus-host disease (GVHD) following major surgeries.
- Studied seven patients (six open heart surgery, one hepatectomy) who received homologous blood transfusions.
Observation:
- All patients developed erythroderma and hyperthermia approximately 10 days post-operation.
- Skin biopsies confirmed acute GVHD in all cases.
- Observed decreased CD3+ and CD4+ T lymphocytes postoperatively, with some CD3+ T cells increasing after day 14.
Findings:
- Patients undergoing open heart surgery died between postoperative days 17-21; the hepatectomy patient died on day 29.
- Postoperative interleukin-2 (IL-2) production was low in measured patients.
- Abnormal postoperative lymphocyte subset changes and low IL-2 levels were noted.
Implications:
- Pre- and postoperative assessment of cell-mediated immunity could predict GVHD occurrence.
- Immune monitoring may serve as a valuable tool for preventing post-transfusional GVHD.
- Highlights the critical need for understanding host immunological status in transfusion recipients.