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Transfusion-Associated Graft-Versus-Host Disease in Adults

Transfusion-associated graft-versus-host disease (TA-GVHD) is a rare but fatal complication of blood transfusion that usually develops two to 30 days following a blood transfusion giving rise to graft versus host disease (GVHD) clinical features that are consisting of fever, skin rash, jaundice, dia...

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Autores principales: Elmakki, Erwa Eltayib, Madkhali, Mohammed Ali, Oraibi, Omar, Alqassimi, Sameer, Saleh, Eman
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10518734/
https://www.ncbi.nlm.nih.gov/pubmed/37753040
http://dx.doi.org/10.7759/cureus.44148
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author Elmakki, Erwa Eltayib
Madkhali, Mohammed Ali
Oraibi, Omar
Alqassimi, Sameer
Saleh, Eman
author_facet Elmakki, Erwa Eltayib
Madkhali, Mohammed Ali
Oraibi, Omar
Alqassimi, Sameer
Saleh, Eman
author_sort Elmakki, Erwa Eltayib
collection PubMed
description Transfusion-associated graft-versus-host disease (TA-GVHD) is a rare but fatal complication of blood transfusion that usually develops two to 30 days following a blood transfusion giving rise to graft versus host disease (GVHD) clinical features that are consisting of fever, skin rash, jaundice, diarrhea, and pancytopenia. The disease is fulminant in most patients with a mortality rate of >90% of cases. The main aim of this review is to enhance awareness among medical practitioners about this fatal disease. Data were extracted manually from the main medical databases (Medline, Scopus, and Google Scholar) after the revision of selected articles and assessed for their contribution to the knowledge of TA-GVHD. TA-GVHD occurs when the viable donor T-cells in the blood or blood products attack the recipient's tissues which his/her immune system is incapable to destroy due to several reasons. The recipient's tissues that are usually involved in TA-GVHD include the liver, intestine, skin, lungs, and bone marrow. Any blood component either whole blood, packed red blood cells (RBCs), platelets, or fresh non-frozen plasma that contains viable T lymphocytes can cause TA-GVHD. Host immunodeficiency, transfusion of fresh blood, and partial human leukocyte antigen (HLA) matching between the donors and the recipients represent the major risk factors of TA-GVHD. Partial HLA matching includes immunocompetent recipients who receive blood from a first-degree relative also, seen in genetically homogenous populations because of high rates of consanguineous marriage. The diagnosis of TA-GVHD is mainly suspected based on clinical manifestations. However, a histopathological study of either skin or rectal biopsy is diagnostic. The treatment of TA-GVHD is generally not effective, unless the patient received emergency stem cell transplantation, while prevention via irradiation of blood or blood products represents the standard of care for this disease. In conclusion, medical practitioners should have a high index of suspicion for this disease. Moreover, future clinical trials targeting and comparing the outcomes of the different therapeutic options for TA-GVHD are required.
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spelling pubmed-105187342023-09-26 Transfusion-Associated Graft-Versus-Host Disease in Adults Elmakki, Erwa Eltayib Madkhali, Mohammed Ali Oraibi, Omar Alqassimi, Sameer Saleh, Eman Cureus Internal Medicine Transfusion-associated graft-versus-host disease (TA-GVHD) is a rare but fatal complication of blood transfusion that usually develops two to 30 days following a blood transfusion giving rise to graft versus host disease (GVHD) clinical features that are consisting of fever, skin rash, jaundice, diarrhea, and pancytopenia. The disease is fulminant in most patients with a mortality rate of >90% of cases. The main aim of this review is to enhance awareness among medical practitioners about this fatal disease. Data were extracted manually from the main medical databases (Medline, Scopus, and Google Scholar) after the revision of selected articles and assessed for their contribution to the knowledge of TA-GVHD. TA-GVHD occurs when the viable donor T-cells in the blood or blood products attack the recipient's tissues which his/her immune system is incapable to destroy due to several reasons. The recipient's tissues that are usually involved in TA-GVHD include the liver, intestine, skin, lungs, and bone marrow. Any blood component either whole blood, packed red blood cells (RBCs), platelets, or fresh non-frozen plasma that contains viable T lymphocytes can cause TA-GVHD. Host immunodeficiency, transfusion of fresh blood, and partial human leukocyte antigen (HLA) matching between the donors and the recipients represent the major risk factors of TA-GVHD. Partial HLA matching includes immunocompetent recipients who receive blood from a first-degree relative also, seen in genetically homogenous populations because of high rates of consanguineous marriage. The diagnosis of TA-GVHD is mainly suspected based on clinical manifestations. However, a histopathological study of either skin or rectal biopsy is diagnostic. The treatment of TA-GVHD is generally not effective, unless the patient received emergency stem cell transplantation, while prevention via irradiation of blood or blood products represents the standard of care for this disease. In conclusion, medical practitioners should have a high index of suspicion for this disease. Moreover, future clinical trials targeting and comparing the outcomes of the different therapeutic options for TA-GVHD are required. Cureus 2023-08-26 /pmc/articles/PMC10518734/ /pubmed/37753040 http://dx.doi.org/10.7759/cureus.44148 Text en Copyright © 2023, Elmakki et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Internal Medicine
Elmakki, Erwa Eltayib
Madkhali, Mohammed Ali
Oraibi, Omar
Alqassimi, Sameer
Saleh, Eman
Transfusion-Associated Graft-Versus-Host Disease in Adults
title Transfusion-Associated Graft-Versus-Host Disease in Adults
title_full Transfusion-Associated Graft-Versus-Host Disease in Adults
title_fullStr Transfusion-Associated Graft-Versus-Host Disease in Adults
title_full_unstemmed Transfusion-Associated Graft-Versus-Host Disease in Adults
title_short Transfusion-Associated Graft-Versus-Host Disease in Adults
title_sort transfusion-associated graft-versus-host disease in adults
topic Internal Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10518734/
https://www.ncbi.nlm.nih.gov/pubmed/37753040
http://dx.doi.org/10.7759/cureus.44148
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