scholarly journals Transfusion-associated graftversus- host disease: A brief comment on blood safety

2021 ◽  
Vol 13 (3) ◽  
Author(s):  
Palma Manduzio
Keyword(s):  
Graft Versus Host Disease ◽  
Blood Components ◽  
Blood Safety ◽  
Host Disease ◽  
Graft Versus Host ◽  
Vulnerable Patients

Dear Editor, A recent paper from Dr Elliot published in Transfusion, entitled ‘Missed irradiation of cellular blood components from vulnerable patients: Insight from 10 years of SHOT data’ updates on Transfusion-associated graft-versus-host disease and blood safety [...].

Guidelines on gamma irradiation of blood components for the prevention of transfusion-associated graft-versus-host disease

1996 ◽  
Vol 6 (3) ◽  
pp. 261-271 ◽  
Author(s):  
J. Chapman ◽  
R. D. Finney ◽  
K. Forman ◽  
P. Kelsey ◽  
S. M. Knowles ◽  
...  
Keyword(s):  
Gamma Irradiation ◽  
Graft Versus Host Disease ◽  
Blood Components ◽  
Host Disease ◽  
Graft Versus Host

scholarly journals Toxic Epidermal Necrolysis and Graft versus Host Disease after Hematopoietic and Liver Transplantation: A Review

2018 ◽  
Vol 3 (1) ◽  
Keyword(s):  
Liver Transplantation ◽  
Toxic Epidermal Necrolysis ◽  
Graft Versus Host Disease ◽  
Total Body Surface Area ◽  
Liver Transplants ◽  
Host Disease ◽  
Graft Versus Host ◽  
Histocompatibility Complex ◽  
Vulnerable Patients ◽  
Total Body

Background: Although rarely reported, Graft versus Host Disease (GvHD) and Toxic Epidermal Necrolysis (TEN) may complicate recovery in patients who undergo hematopoietic cell, and organ transplantation. Skin manifestations can appear clinically similar or overlap. The objective of this study was to determine whether there are any parameters, which distinguished these two conditions during transplantation. Methods: A literature search for TEN only and combined TEN/GvHD cases after hematopoietic or liver transplantation between 1970 and 2015 was performed. Results: Of 34 cases, there were 14 cases of TEN and 20 of combined TEN/GvHD after hematopoietic or liver transplantation. Patients with TEN had a median age of 41 (range 22-56) years compared to patients with TEN/ GvHD who had a median age of 29 (range 18-52) years. Percent total body surface area (TBSA) skin involvement was a median of 50 (range 23-87) %TBSA in the TEN group and 55 (range 30-80) %TBSA in the TEN/GvHD group. Mortality was 71.4% in the TEN group (10 of 14) and 95% in those with concurrent TEN/GvHD (19 of 20). Conclusions: Development of both TEN and GvHD after hematopoietic or liver transplantation heralded a poor prognosis. TEN was frequently precipitated by co-trimoxazole and allopurinol, medications frequently used during transplantation. GvHD was more likely to start before TEN if both were diagnosed. If Grade IV GvHD occurred, it was difficult to determine if TEN had also complicated the picture. More patients with HSCT developed TEN/GvHD compared to patients with BMT and liver transplants. Future treatment directions may utilize major histocompatibility complex genetic drug susceptibilities testing to prevent the development of TEN during the transplantation in vulnerable patients. Although still in the early stages, several studies have shown that cyclosporine, which is used to treat patients with GvHD, may also be beneficial in decreasing mortality in patients with TEN.

Transfusion associated graft-versus-host disease in DiGeorge syndrome—index case report with survey of screening procedures and use of irradiated blood components

1996 ◽  
Vol 6 (3) ◽  
pp. 222-227 ◽  
Author(s):  
Rodney C. G. Franklin ◽  
Obed Onuzo ◽  
Paul A. Miller ◽  
David Goldblatt ◽  
David Cummins
Keyword(s):  
Graft Versus Host Disease ◽  
Digeorge Syndrome ◽  
Screening Method ◽  
Disease Assessment ◽  
Blood Components ◽  
Host Disease ◽  
Graft Versus Host ◽  
The United Kingdom ◽  
The Republic ◽  
High Level

SummaryMost patients with DiGeorge syndrome require surgery to their heart defect during infancy and are at risk of developing transfusion-associated graft-versus-host disease if non-irradiated blood is used perioperatively. Because of its wide clinical variability, DiGeorge syndrome may not be recognized before surgery and thus a high level of vigilance is required. An infant is described who developed fatal graft-versus-host disease after receiving non-irradiated blood components during surgery for classical tetralogy of Fallot; the postoperative clinical course and autopsy findings were consistent with underlying DiGeorge syndrome. An informal survey of the 18 pediatric cardiology units in the United Kingdom and the Republic of Ireland showed no consensus as to which patients should be screened for DiGeorge syndrome, which screening test to use and to whom irradiated blood components should or should not be given to prevent transfusion associated graft-versus-host disease. Assessment of T-cell numbers appears to be the preferred screening method to determine those who might benefit from receiving such therapy.

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