Orlin J B, Ellis M H
Blood Bank, Rabin Medical Center, Petach Tikva, Israel.
Curr Opin Hematol. 1997 Nov;4(6):442-8. doi: 10.1097/00062752-199704060-00015.
Transfusion-associated graft-versus-host disease (TA-GVHD) is a devastating immunologic complication of blood transfusion. Patients at highest risk include premature infants and other patients who are immunosuppressed as a result of either congenital or acquired disease or because of the administration of immunosuppressive therapy. An additional high-risk group is immunocompetent patients who are heterozygous at a particular HLA locus and who receive blood from a donor who is homozygous at the same locus. The clinical syndrome consists of fever, skin rash, diarrhea, hepatic dysfunction, and bone marrow aplasia. The outcome is nearly always fatal, despite attempted treatments that have included the use of immunosuppressive agents. Hemorrhage and infection are the most common causes of death. Both humoral and cytotoxic mechanisms have been implicated in the pathophysiology of TA-GVHD. The complication of TA-GVHD can be prevented by the use of irradiated blood components. The use of ultraviolet B light-irradiated blood products and leukoreduction filters are also being investigated as potential preventive treatment modalities.
输血相关移植物抗宿主病（TA-GVHD）是一种严重的输血免疫并发症。高危患者包括早产儿以及因先天性或后天性疾病或免疫抑制治疗而免疫抑制的其他患者。另一个高危群体是在特定HLA位点杂合的免疫功能正常患者，他们接受来自同一基因座纯合供体的血液。临床综合征包括发热、皮疹、腹泻、肝功能障碍和骨髓再生障碍。尽管尝试了包括使用免疫抑制剂在内的治疗方法，但结果几乎总是致命的。出血和感染是最常见的死亡原因。体液和细胞毒性机制都与TA-GVHD的病理生理学有关。使用辐照血液成分可预防TA-GVHD并发症。紫外线B光辐照血液制品和白细胞滤除器也正在作为潜在的预防性治疗方式进行研究。
