Dwyre D M, Holland P V
Department of Pathology, University of California Davis Medical Center, Sacramento, CA 95817, USA.
Vox Sang. 2008 Aug;95(2):85-93. doi: 10.1111/j.1423-0410.2008.01073.x. Epub 2008 Jun 9.
Transfusion-associated graft-versus-host disease (TA-GvHD) is a rare complication of transfusion of cellular blood components producing a graft-versus-host clinical picture with concomitant bone marrow aplasia. The disease is fulminant and rapidly fatal in the majority of patients. TA-GvHD is caused by transfused blood-derived, alloreactive T lymphocytes that attack host tissue, including bone marrow with resultant bone marrow failure. Human leucocyte antigen similarity between the transfused lymphocytes and the host, often in conjunction with host immunosuppression, allows tolerance of the grafted lymphocytes to survive the host immunological response. Any blood component containing viable T lymphocytes can cause TA-GvHD, with fresher components more likely to have intact cells and, thus, able to cause disease. Treatment is generally not helpful, while prevention, usually via irradiation of blood components given to susceptible recipients, is the key to obviating TA-GvHD. Newer methods, such as pathogen inactivation, may play an important role in the future.
输血相关移植物抗宿主病（TA-GvHD）是一种罕见的细胞血液成分输血并发症，会产生移植物抗宿主的临床表现，并伴有骨髓再生障碍。该病在大多数患者中病情凶险且进展迅速，可导致死亡。TA-GvHD是由输入的血液来源的同种异体反应性T淋巴细胞攻击宿主组织引起的，包括骨髓，进而导致骨髓衰竭。输入的淋巴细胞与宿主之间的人类白细胞抗原相似性，通常与宿主免疫抑制共同作用，使得移植的淋巴细胞能够耐受宿主的免疫反应而存活下来。任何含有存活T淋巴细胞的血液成分都可导致TA-GvHD，较新鲜的成分更可能含有完整细胞，因此更易引发疾病。治疗通常无效，而预防（通常是对易感受血者输入的血液成分进行辐照）是避免TA-GvHD的关键。诸如病原体灭活等新方法未来可能发挥重要作用。
