Transfusion associated graft versus host disease
This chapter discusses graft versus host diseases associated with transfusion (TA-GVHD). Transfusion associated graft versus host disease are rare and almost universally fatal complication of blood product transfusion. The disease occurs due to the co-transfusion of viable lymphocytes in cellular blood products, such as whole blood, red blood cells, platelets, granulocytes and fresh plasma. If the immune system of the recipient cannot recognize and destroy the co-transfused lymphocytes, they can engraft and mount an immunologic response against the host. A number of technologies can abrogate the risk of TA-GVHD in these include irradiation of the product and pathogen-reduction and both of these methods render the DNA in the co-transfused lymphocytes incapable of participating in cell division. The development of TA-GVHD occurs in three phases: conditioning phase, afferent phase and efferent phase. Treatment of TA-GVHD is largely palliative and aimed at attempting to improve the function or render recovery of the recipient's immune system and bone marrow.
