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Transfusion associated graft‐versus‐host disease after cardiac surgery: response to antithymocyte‐globulin and corticosteroid therapy
Author(s) -
Prince M.,
Szer J.,
Weyden M. B.,
Pedersen J. S.,
Holdsworth R. F.,
Whyte G.
Publication year - 1991
Publication title -
australian and new zealand journal of medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 0004-8291
DOI - 10.1111/j.1445-5994.1991.tb03000.x
Subject(s) - medicine , pancytopenia , graft versus host disease , rash , disease , corticosteroid , transfusion therapy , surgery , immunology , bone marrow , complication , blood transfusion , transplantation
A 63‐year‐old patient developed graft‐versus‐host disease (GVHD) after the transfusion of stored, random donor red cell concentrates with coronary artery surgery. The disease was characterised by skin rash, fever, diarrhoea, hepatic dysfunction, pancytopenia and the acquisition of cells bearing human leukocyte antigens of a blood donor. Clinical and histologic improvements were noted with antithymocyte‐globulin and corticosteroid therapy, as seen in some patients with acute GVHD following allogeneic bone marrow transplantation, but the pancytopenia failed to resolve prior to a fatal cerebral haemorrhage. Early aggressive immunosuppressive therapy may be beneficial for transfusion‐associated GVHD but strategies for its prevention, by limitation of the use of homologous blood need to be addressed.