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THE JOURNAL OF CARDIOVASCULAR SURGERY
Rivista di Chirurgia Cardiaca, Vascolare e Toracica
Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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ORIGINAL ARTICLES CARDIAC PAPERS
The Journal of Cardiovascular Surgery 2000 Giugno;41(3):377-80
Transfusion-associated graft-versus-host disease with transfusion practice in cardiac surgery
Yasuura K., Okamoto H., Matsuura A.
From the Department of Thoracic Surgery Nagoya University School of Medicine, Nagoya, Japan
Background. Transfusion-associated graft-versus-host disease (TA-GVHD) in immunocompetent patients has still been underdiagnosed and underreported. Risk of TA-GVHD caused by transfusion practice in cardiac surgery should be appropriately recognized.
Methods. The correlation of TA-GVHD with transfusion practice in cardiac surgery was analyzed from our 17-year clinical experience. We retrospectively reviewed 2686 consecutive adult patients who underwent cardiac surgery between 1980 and 1996. Classified according to transfusion practice, 847 patients (32%) received nonirradiated fresh homologous whole blood (mean per patient, 5±2 units) with or without other blood components; 592 patients (22%) nonirradiated stored RBCs older than 7 days (4±2), and 551 patients (21%) received irradiated homologous blood including, fresh whole blood (2±1), RBCs (4±1), and PCs (8±3), respectively. The remaining 696 patients (25%), did not require homologous transfusion.
Results. Four of 847 patients who received nonirradiated fresh homologous whole blood (≤48 hours after donation) developed TA-GVHD. TA-GVHD did not occur in other patients.
Conclusions. Our local experience demonstrates the incidence of TA-GVHD in patients who received fresh homologous whole blood in cardiac surgery was much higher, compared with previous reports. This result suggests that the frequency of TA-GVHD is nearly similar to the value calculated from the proportion of HLA haplotypes in the population.