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This is a rare but fatal reaction where transfused patients present with fever, rash, liver function abnormalities and pancytopenia.
Severely immunocompromised recipients are at greatest risk.
It has been reported in immunologically normal recipients heterozygous for a tissue antigen haplotype for which the donor is homozygous, especially directed donations from family members.
Viable T lymphocytes in the transfused component engraft in the recipient and react against tissue antigens in the recipient.
Request for skin biopsy. Demonstrate donor leucocyte engraftment.
Provide supportive care.
Prevention is by gamma irradiation.