Transfusion-associated graft-versus-host disease and its prevention

Blood Rev. 1995 Dec;9(4):251-61. doi: 10.1016/s0268-960x(95)90016-0.


Transfusion-associated graft-versus-host disease is a rare but usually fatal complication of transfusion of cellular blood components, caused by multiorgan engraftment and proliferation of donor T lymphocytes. The classical features of skin rash, diarrhoea and hepatitis, along with striking bone-marrow failure, are seen 1-2 weeks after transfusion. Although early reports described the condition only in immunosuppressed individuals, sharing of an HLA haplotype between donor and an immunocompetent recipient can also result in transfusion-associated graft-versus-host disease. The condition is entirely preventable by gamma irradiation of cellular blood components to 25 Gy, although this results in some reduction of red-cell viability and increased loss of red-cell potassium. The major indications for irradiated blood components include bone marrow/stem cell auto- or allografting, Hodgkin's disease, intrauterine transfusions, and transfusions from relatives or HLA-selected platelet donors.

Publication types

  • Review

MeSH terms

  • Blood Donors*
  • Erythrocytes / radiation effects
  • Female
  • Gamma Rays
  • Graft vs Host Disease / diagnosis
  • Graft vs Host Disease / immunology*
  • Graft vs Host Disease / therapy
  • HLA Antigens / blood*
  • HLA Antigens / genetics
  • Haplotypes
  • Humans
  • Infant, Newborn
  • Lymphocytes / radiation effects
  • Pregnancy
  • Transfusion Reaction*


  • HLA Antigens