Graft-versus-Host Disease Associated with Transfusion of Blood from Unrelated HLA-Homozygous Donors

Graft-versus-host disease (GVHD) is a well-known complication of allogeneic bone marrow transplantation and is increasingly being recognized after solid-organ transplantation and transfusion1–3. Like GVHD occurring after bone marrow transplantation, transfusion-associated GVHD is characterized by fever, skin rash, diarrhea, and hepatitis. However, transfusion-associated GVHD typically occurs much sooner (median, 10 to 12 days after transfusion), is frequently associated with bone marrow aplasia, usually does not respond to immunosuppressive therapy, and is fatal in most cases4–10. Since gamma irradiation of cellular blood components before transfusion can prevent the development of transfusion-associated GVHD, it is critical to identify susceptible . . .