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ULTIMO FASCICOLOTHE 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
Impact Factor 1,632

Periodicità: Bimestrale

ISSN 0021-9509

Online ISSN 1827-191X

 

The Journal of Cardiovascular Surgery 2000 Giugno;41(3):377-80

CARDIAC PAPERS 

 ORIGINAL ARTICLES

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.

lingua: Inglese


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