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VOLUME 12 , ISSUE 3 ( September, 2008 ) > List of Articles

CASE REPORT

Transfusion associated graft versus host disease in an immunocompetent individual following coronary artery bypass grafting

M. N. Ramakrishna, Devi Prasad Hegde, Ratan Gupta, Girish T. Nagendra, Sharad Damodar

Keywords : Cardiopulmonary bypass, engraftment, immunocompetent, irradiation, transfusion

Citation Information : Ramakrishna MN, Hegde DP, Gupta R, Nagendra GT, Damodar S. Transfusion associated graft versus host disease in an immunocompetent individual following coronary artery bypass grafting. Indian J Crit Care Med 2008; 12 (3):124-127.

DOI: 10.4103/0972-5229.43681

License: CC BY-ND 3.0

Published Online: 01-09-2008

Copyright Statement:  Copyright © 2008; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Transfusion associated graft versus host disease (TA-GVHD) is a rare but commonly fatal complication of transfusion of cellular blood products, which usually occurs in immunosuppressed individuals following transfusion and subsequent engraftment of viable T lymphocytes. Very rarely it may arise in apparently immunocompetent individuals. The clinical syndrome consists of fever, skin rash, diarrhoea, hepatic dysfunction, and bone marrow aplasia. The outcome is nearly always fatal. We present here a case report of fatal TA-GVHD in a “presumed” immunocompetent patient, post coronary artery bypass grafting surgery after transfusion of blood products. The patient died 24 days after transfusion. There is a perceived increased risk of TA-GVHD following bypass grafting and other surgical procedures where cardiopulmonary bypass is required. TA-GVHD is probably underreported and the incidence is felt to be too low to warrant routine irradiation of cellular products for this group of patients. Clinicians, pathologists, and transfusion centers should be aware of this rare but devastating complication of blood transfusion after cardiac surgery.


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  1. In: Webb IJ, Anderson KC, editors. Scientific basis of transfusion medicine: Implications for clinical practice: 2nd ed. 2000. P. 420-6.
  2. Transfusion-associated graft versus-host disease. Br J Hematol 2002;117:275-87.
  3. Transfusion associated graft versus host disease in immunocompetent patients: Case series and review of literature. Transfusion 2007;47:1405-11.
  4. Transfusion associated graft versus host disease in non immunocompromised hosts. Transfusion 1990;30:101-3.
  5. Survey of transfusion associated graft versus host disease in immunocompetent recipients. Transfus Med Rev 1996;10:31-43.
  6. Fatal transfusion-associated graft-versus-host disease in an immunocompetent recipient of a volunteer unit of red cells. Transfusion 2006;46:885-8.
  7. Comparison of the hemostatic effects of fresh whole blood, stored whole blood and components after open heart surgery in children. Blood 1991;77:930-6.
  8. Post transfusion graft versus host disease occurring in non immunosuppressed patients in Japan. Transfus Sci 1991;12:281-9.
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