Lillevang S T, Kristensen T
Klinisk immunologisk afdeling. Odense Sygehus.
Ugeskr Laeger. 1992 Oct 19;154(43):2964-8.
Transfusion-associated graft-versus-host disease (TA-GVHD) is a serious, often fatal complication to the transfusion of blood components. TA-GVHD is caused primarily by donor T lymphocytes reacting towards recipient MHC antigens. The diagnosis TA-GVHD should be considered when patients, within a month of receiving blood transfusion, develop sudden, unexpected high fever and erythematous rash, possibly accompanied by gastrointestinal symptoms and/or pancytopenia. Congenital (cellular) immune defect, intrauterine transfusion, bone marrow transplantation, Hodgkin's disease, and directed transfusions (especially from first degree relatives) all carry high risk of developing TA-GVHD. Since mortality exceeds 90% irrespective of any treatment, prevention is essential. Pretransfusion gamma-irradiation of blood components with a 25 Gy dose effectively prevents TA-GVHD, and it is therefore recommended that all blood components be irradiated prior to transfusion to patients belonging to defined groups-at-risk.
输血相关移植物抗宿主病（TA-GVHD）是输血成分时一种严重且常致命的并发症。TA-GVHD主要由供体T淋巴细胞对受体MHC抗原产生反应所致。当患者在输血后一个月内突然出现意外的高热和红斑皮疹，可能伴有胃肠道症状和/或全血细胞减少时，应考虑TA-GVHD的诊断。先天性（细胞）免疫缺陷、宫内输血、骨髓移植、霍奇金病以及定向输血（尤其是来自一级亲属的输血）都具有发生TA-GVHD的高风险。由于无论采取何种治疗，死亡率均超过90%，因此预防至关重要。用25 Gy剂量对血液成分进行输血前γ射线照射可有效预防TA-GVHD，因此建议对属于特定高危组的患者输血前对所有血液成分进行照射。
