[Transfusion associated graft versus host disease following cardiovascular surgery]

Area of Science:

• Cardiovascular Surgery
• Transfusion Medicine
• Immunology

Background:

• Transfusion-associated graft versus host disease (TA-GVHD) is a rare but severe complication following blood transfusions.
• Cardiovascular surgery patients are particularly vulnerable due to immunosuppression and the need for multiple transfusions.

Observation:

• A 62-year-old male developed TA-GVHD post-coronary artery bypass grafting and mitral annuloplasty.
• Symptoms included fever, liver dysfunction, skin rash, and hypoplastic bone marrow, appearing ten days after surgery.
• Other potential causes like drug reactions and infections were excluded through clinical and histopathological evaluation.

Findings:

• The patient had received five units of blood, including one unit from a close relative.
• The transfusion from the relative was identified as the likely cause of TA-GVHD.
• Histopathological examination of skin biopsy confirmed the diagnosis.

Implications:

• This case highlights the critical need to avoid transfusions from relatives in patients undergoing major operations, especially cardiovascular surgery.
• Irradiation of blood products before transfusion is recommended to prevent TA-GVHD in at-risk populations.
• Awareness and adherence to transfusion guidelines are crucial for patient safety in surgical settings.