Please use this identifier to cite or link to this item: https://hdl.handle.net/2440/92713
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Type: Journal article
Title: A systematic review of transfusion-associated graft-versus-host disease
Author: Kopolovic, I.
Ostro, J.
Tsubota, H.
Lin, Y.
Cserti-Gazdewich, C.
Messner, H.
Keir, A.
DenHollander, N.
Dzik, W.
Callum, J.
Citation: Blood, 2015; 126(3):406-414
Publisher: American Society of Hematology
Issue Date: 2015
ISSN: 0006-4971
1528-0020
Statement of
Responsibility: 
Ilana Kopolovic, Jackie Ostro, Hideki Tsubota, Yulia Lin, Christine M. Cserti-Gazdewich, Hans A. Messner, Amy K. Keir, Neal DenHollander, Walter S. Dzik, and Jeannie Callum
Abstract: Transfusion-associated graft-versus-host disease (TA-GVHD) is a rare complication of blood transfusion. The clinicolaboratory features of TA-GVHD, and the relative contributions of recipient and component factors remain poorly understood. We conducted a systematic review of TA-GVHD reports. The Human Leukocyte Antigen (HLA) relationship between donor and recipient was classified as D=0 when no donor antigens were foreign to the recipient, versus D≥1 when ≥1 donor antigen disparity occurred. We identified 348 unique cases. Criteria for component irradiation were met in 48.9% cases(34.5% immune-compromised, 14.4% related-donor), though non-irradiated components were transfused in the vast majority of these(97.6%). Components were typically whole blood and red cells. When reported, component storage duration was ≤10 days in 94%, and 23(6.6%) were leukoreduced (10 bedside, 2 pre-storage, 11 unknown). Among 84 cases with HLA data available, the category of D=0 was present in 60(71%) patients at either HLA class I or II loci, and was more common among recipients without traditional indications for component irradiation. These data challenge the historic emphasis on host immune defects in the pathogenesis of TA-GVHD. The dominant mechanism of TA-GVHD in both immunocompetent and compromised hosts is exposure to viable donor lymphocytes not recognized as foreign by, but able to respond against, the recipient.
Keywords: Humans
Graft vs Host Disease
Transfusion Reaction
Description: Accepted April 14, 2015.
Rights: © 2015 American Society of Hematology
DOI: 10.1182/blood-2015-01-620872
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