Transfusion-acquired Graft-versus-host Disease
When to suspect this adverse reaction?
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.
Usual cause?
Viable T lymphocytes in the transfused component engraft in the recipient and react against tissue antigens in the recipient.
Investigation
Request for skin biopsy. Demonstrate donor leucocyte engraftment.
What to do?
Provide supportive care.
Prevention is by gamma irradiation.
