Graft-vs-host disease

Background

• Acute vs Chronic
  • Acute: 1-12 weeks post graft (<100 days)
  • Chronic: >12 weeks
• Transplanted graft with immunologically competent cells stimulated by host antigens and host is incapable of mounting an effective immunologic response
• Occurs in leukemia/lymphoma or immunocompromised
  • Most commonly post HSCT: Hematopoietic stem cell transplant
• Rare in solid organ transplant

Clinical Features

• Nonspecific rash
• Mucositis
• Fever
• Diarrhea

Differential Diagnosis

Transfusion Reaction Types

• Acute
  • Intravascular hemolytic tranfusion reaction
  • Febrile nonhemolytic tranfusion reaction
  • Allergic tranfusion reaction
  • Transfusion-associated circulatory overload (TACO)
  • Transfusion-related acute lung injury (TRALI)
  • Transfusion-associated graft-versus-host disease
  • Fluid overload
  • Sepsis
• Delayed
  • Extravascular hemolytic tranfusion reaction
  • Graft-vs-host disease
  • Transfusion infections

Diagnosis

• LFT abnormalities
• Pancytopenia

Management

• Glucocorticoids

See Also

• Transplant complications
• Transfusions
• Acute transfusion reaction
• Extravascular hemolytic tranfusion reaction
• Graft-vs-host disease