Transfusion-associated graft-versus-host disease (TA-GVHD) is a rare, but fatal complication of blood transfusions. TA-GVHD occurs when donor lymphocytes, not recognized as foreign antigen, mount an immune response against the recipient’s tissue.
While host immune defects, component characteristics and donor-recipient HLA relationships have all been identified as factors associated with TA-GVHD, the relative importance of each factor is unknown. A literature review, covering over 50 years, identified 348 cases of TA-GVHD in 26 countries. The literature review and data from the United Kingdom’s hemovigilance reporting system collectively indicate that recipient immunodeficiency alone may not be enough to cause TA-GVHD. The majority of the TA-GVHD cases involved whole blood or red blood cells. Matching HLA antigens (i.e., blood components with no foreign donor antigens to recipient) were present in over 70% of cases. In addition, fresher blood components stored for 10 days or less were implemented in 94% of cases. Further hemovigilance reporting of transfusion-associated adverse events may help clarify the mechanism of TA-GVHD.
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