Transfusion Medicine Bulletin Vol. Provided in conjunction with America's Blood Centers . These donor lymphocytes proliferate and damage target organs, especially bone marrow, skin, liver, and gastrointestinal tract, which ultimately can be fatal. The disease initially was recognized as a complication of intrauterine transfusion and transfusion to recipients of allogeneic marrow transplant in patients who had received total body irradiation. GVHD also has been seen in other immunologically incompetent patients whose exposure to donor lymphocytes has been from transfusion of cellular blood products or, rarely, a transplanted organ.
Death usually is due to complications of infection or hemorrhage that follow pancytopenia.
The rarity of TA-GVHD and the paucity of published experience make the definition of groups at risk for the disease difficult. A review of experience outside the transplant setting 1 revealed only 87 cases in the literature. Historically, the disease has been underreported, especially among immunocompetent hosts. TA-GVHD also has been documented in 6 infants with erythroblastosis fetalis being treated by exchange or intrauterine transfusion. TA-GVHD is a rarer complication of transfusion in patients with leukemia.