Bojanić Ines, Cepulić Branka Golubić
Zavod za klinicku transfuziologiju, Klinicki zavod za laboratorijsku dijagnostiku KBC-a, Zagreb.
Lijec Vjesn. 2004 Jan-Feb;126(1-2):39-47.
Transfusion-associated graft-versus-host disease (TA-GVHD) is rare but usually fatal complication of transfusion of any blood component containing viable T lymphocytes. TA-GVHD manifests as an acute syndrome characterized by the dysfunction of the skin, liver, gastrointestinal tract and bone marrow. The development of bone marrow aplasia increases the risk for hemorrhage and infection and most patients die within 1 month of transfusion. The risk associated with an individual transfusion depends on the number and viability of contaminated lymphocytes, the susceptibility of the patient's immune system to their engraftment and the degree of disparity in histocompatibility antigens between the donor and the patient. The risk of TA-GVHD are highest in recipients with immunodeficiency or immunosuppression. Prevention of TA-GVHD is of great importance as it cannot be treated successfully. Patients at risk must be identified and transfused with irradiated cellular blood products, as gamma irradiation inhibits the proliferation of donor lymphocytes and is currently the only recommended method for TA-GVHD prevention.
输血相关移植物抗宿主病（TA-GVHD）是一种罕见但通常致命的并发症，发生于输注任何含有存活T淋巴细胞的血液成分时。TA-GVHD表现为一种急性综合征，其特征为皮肤、肝脏、胃肠道和骨髓功能障碍。骨髓再生障碍的发展增加了出血和感染的风险，大多数患者在输血后1个月内死亡。单次输血相关的风险取决于污染淋巴细胞的数量和活力、患者免疫系统对其植入的易感性以及供体与患者之间组织相容性抗原的差异程度。TA-GVHD的风险在免疫缺陷或免疫抑制的受者中最高。由于TA-GVHD无法成功治疗，因此预防极为重要。必须识别出有风险的患者，并输注经过辐照的细胞血液制品，因为伽马射线照射可抑制供体淋巴细胞的增殖，目前是预防TA-GVHD的唯一推荐方法。
