Transfusion Associated Graft Versus Host Disease

Aka: Transfusion Associated Graft Versus Host Disease, TAGVHD

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II. Pathophysiology

  1. Donor Lymphocytes survive, engraft and react against host tissue

III. Risk Factors: Severe Immunosuppresion

  1. Bone Marrow Transplant
  2. Inherited Cellular Immunity Deficiency
  3. Severe Lymphopenia (<300 to 500 Lymphocytes/ul)

IV. Signs

  1. Onset within 5-10 days of transfusion
  2. Fever
  3. Rash
  4. Nausea
  5. Vomiting
  6. Diarrhea

V. Labs

  1. Liver function abnormalities (acute liver injury )
  2. Pancytopenia
    1. Complete marrow aplasia may occur within 21 days of transfusion

VI. Management

  1. Supportive Care

VII. Prevention

  1. Blood Product Irradiation
  2. Blood Product Pathogen Inactivation

VIII. Prognosis

  1. Fatal in 90% of cases

IX. References

  1. Raval (2020) Am Fam Physician 102(1):30-8 [PubMed]
  2. Sharma (2011) Am Fam Physician 83(6): 719-24 [PubMed]

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