Transfusion-associated graft-versus-host disease: an overview and two case reports.

PURPOSE/OBJECTIVES: To describe the pathogenesis, clinical manifestations, and diagnosis of transfusion-associated graft-versus-host disease (TA-GVHD) and to illustrate these concepts using two case reports.

DATA SOURCES

Published articles, books, and the author's clinical experience.

DATA SYNTHESIS

Graft-versus-host disease (GVHD) is most commonly associated with allogeneic bone marrow transplantation (BMT). However, GVHD increasingly is being reported in the non-BMT population. Of particular concern is TA-GVHD, an underrecognized, usually life-threatening complication of supportive care in both immunosuppressed as well as immunocompetent hosts.

CONCLUSION

Most cases of TA-GVHD may be prevented with the use of irradiated blood products.

IMPLICATIONS FOR NURSING PRACTICE

Nurses can have a positive impact on the prevention of this highly morbid disease. Thorough assessment, education, and supportive care are essential when caring for patients with TA-GVHD. Because of ineffective treatment strategies, is-sues surrounding death and dying cannot be overlooked.