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:: Volume 21, Issue 1 (Spring 2024) ::
Sci J Iran Blood Transfus Organ 2024, 21(1): 82-95 Back to browse issues page
Transfusion-associated graft-versus-host disease: pathophysiology, complications, prevention
E. Yazdandoust , S. Amini-Kafiabad
Keywords: Key words: Blood Transfusion, Transfusion Reaction, Graft vs Host Disease, Risk Factors
Full-Text [PDF 738 kb]   (140 Downloads)     |   Abstract (HTML)  (560 Views)
Type of Study: Review Article | Subject: Imunohematology
Published: 2024/03/29
Full-Text:   (109 Views)
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Sci J Iran Blood Transfus Organ 2024;21 (1): 82-95
Review Article
 
 Transfusion-associated graft-versus-host disease: pathophysiology, complications, prevention

Yazdandoust E.1, Amini-Kafiabad S.1


1Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran


Abstract
Background and Objectives
Transfusion-associated graft-versus-host disease (TA-GVHD) is a rare and fatal complication caused by blood transfusion. In this condition, donated lymphocyte cells attack host tissues. In this review article, the history, prevalence, pathogenesis, clinical symptoms, risk factors, diagnostic methods, strategies to reduce its occurrence, prognosis, disease management, and laboratory characteristics of this condition are discussed.

Materials and Methods
For this purpose, a search was made using published reliable research in Google Scholar, PubMed, and MEDLINE databases and the findings of more than 70 articles were cited.

Results
The following study showed that live T lymphocytes from donated blood products and the resulting cytokine storm play a role in the occurrence of this complication. The symptoms of this disease appear in the form of skin rash, pancytopenia, and fever, and its diagnosis is based on clinical symptoms and laboratory findings of skin biopsy, increased liver enzymes, confirmation of lymphocyte chimerism using STR-PCR, and determination of the HLA phenotype of lymphocytes and FISH method. This complication has a higher prevalence in populations with high genetic similarity or people with immune deficiencies, however, it also occurs in other people who do not have these conditions or who have partial donor-recipient HLA matching (one-way HLA matching).

Conclusions 
This complication is one of the fatal complications caused by blood transfusion that occurs within 2 to 30 days after blood products transfusion; the typical cases are associated with more than 90% mortality and mild or atypical cases have longer survival and are associated with a better prognosis that may go undetected or be treated spontaneously.

Key words: Blood Transfusion, Transfusion Reaction, Graft vs Host Disease, Risk Factors







Received:  29 Jan 2024
Accepted: 27 Feb 2024



Correspondence: Amini Kafi-Abad S., MD. Pathologist. Professor of Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine.
P.O.Box: 14665-1157, Tehran, Iran. Tel: (+9821) 88601573; Fax: (+9821) 88601555
E-mail: s.amini@ibto.ir
 
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Yazdandoust E, Amini-Kafiabad S. Transfusion-associated graft-versus-host disease: pathophysiology, complications, prevention. Sci J Iran Blood Transfus Organ 2024; 21 (1) :82-95
URL: http://bloodjournal.ir/article-1-1526-en.html
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فصلنامه پژوهشی خون Scientific Journal of Iran Blood Transfus Organ
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