Transfusion-associated graft-versus-host disease in a liver transplant recipient: an unusual presentation and review of the literature

Transfusion
Kerry L O'BrienTheresa Nester

Abstract

Transfusion-associated graft-versus-host disease (TA-GVHD) is a rare, nearly universally fatal complication from transfusion of nonirradiated cellular blood components, occurring when a recipient's immune system is unable to recognize and destroy transfused T lymphocytes. Irradiation of cellular components eliminates this risk. We present an unusual case of a liver transplant recipient developing TA-GVHD 13 weeks after transfusion of a random unit of nonirradiated red blood cells (RBCs) that happened to be from a donor homozygous for an HLA haplotype shared by the patient. This study was a single case review of a liver transplant recipient who developed skin GVHD and marrow aplasia. Clinical course and the chimerism studies involving the patient, the liver donor, and the blood donor are detailed. The patient presented 3 months posttransplant with GVHD of his skin and marrow aplasia. In addition to standard antigraft immunosuppression, this patient had started the interleukin-1 receptor antagonist anakinra on Posttransplant Day 13 for an acute gout flare. Chimerism studies on the patient's peripheral blood identified a population of CD3 cells that did not originate with either the patient or his liver donor. HLA studies and micr...Continue Reading

References

Jul 4, 1985·Nature·A J JeffreysS L Thein
Jan 1, 1996·Transfusion Medicine Reviews·H Ohto, K C Anderson
Mar 29, 2001·Transfusion·D J Triulzi, M A Nalesnik
Jun 12, 2008·Vox Sanguinis·D M Dwyre, P V Holland
Dec 6, 2008·Transfusion Medicine Reviews·Heiko RühlUlrich J H Sachs
Mar 30, 2010·Transfusion·Kerry L O'BrienBernard J Roth
Jul 27, 2010·Transfusion and Apheresis Science : Official Journal of the World Apheresis Association : Official Journal of the European Society for Haemapheresis·M E SteinerC P Stowell
Aug 6, 2011·International Journal of Rheumatic Diseases·Ai P Tran, Jack Edelman
Sep 3, 2011·Indian Journal of Hematology & Blood Transfusion : an Official Journal of Indian Society of Hematology and Blood Transfusion·Ketan K PatelApurva P Shah

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Citations

Mar 22, 2014·Vox Sanguinis·M C KatusN M Dunbar
Apr 27, 2016·Hematology/oncology Clinics of North America·Eric A Gehrie, Nancy M Dunbar
Dec 3, 2014·Anaesthesia·S HartS A McCluskey
Jan 13, 2015·Experimental and Therapeutic Medicine·Dai-Yu LiHua Zhao
Aug 19, 2020·British Journal of Haematology·Theodora FoukaneliUNKNOWN BCSH Committee

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