Fatal transfusion‐associated graft‐versus‐host disease in an immunocompetent recipient of a volunteer unit of red cells

Abstract

This is the first reported case in the United States of fatal TAGVHD from RBCs in an immunocompetent patient who received a randomly selected unit of RBCs from a donor who was homozygous for a shared HLA haplotype. The policy of selective irradiation should be reexamined.

Guidelines on the use of irradiated blood components prepared by the British Committee for Standards in Haematology blood transfusion task force

“…TA‐GvHD is a very rare but usually fatal complication following transfusion of lymphocyte‐containing blood components. Although the first reports concerned cases where viable allogeneic lymphocytes had been transfused into immunosuppressed recipients (von Fliedner et al , 1982; Burns et al , 1984; Anderson & Weinstein, 1990), it became apparent that non‐immunosuppressed patients could also experience this problem, particularly if the blood components they received came from an HLA haploidentical unrelated donor or family member (Ohto et al , 1992; Aoun et al , 2003; Serefhanoglu et al , 2005; Triulzi et al , 2006; Agbaht et al , 2007).…”

Transfusion-Associated Microchimerism in Combat Casualties

“…40,41 TA-GVHD is extremely rare and most commonly occurs in immunodeficient patients, although isolated reports of TA-GVHD in immunocompetent patients have been documented. [42][43][44] In summary, these preliminary data do not demonstrate a significantly increased rate of TA-MC in recipients of FrWB or plts compared with RBCs. Larger studies are needed to determine whether there is an increased rate of TA-MC in combat casualties transfused with FrWB.…”

Transfusion associated graft versus host disease in an immunocompetent individual following coronary artery bypass grafting

“…[56] The reasons for this are not entirely clear but it is thought, that the use of relatively fresh blood with more viable lymphocytes increases the chance of engraftment.…”