The role of blood from HLA-homozygous donors in fatal transfusion-associated graft-versus-host disease after open-heart surgery

Article Abstract:

Graft-versus-host disease (GVHD) occurs in patients receiving tissue transplants or blood products from another donor. The condition usually arises because it is necessary to suppress the immune response in the recipient to facilitate transplantation and reduce the possibility of rejection. The depressed immune response may lead to a situation in which the recipient's own organs begin to be attacked as "foreign." In two patients who had heart surgery, rashes, low blood cell count, fever, and hepatitis developed after blood donated by family members was transfused. Fresh blood from family members was used in an effort to prevent infection with the human immunodeficiency virus (HIV). However, fresh blood donated from HLA (human leukocyte antigen)-homologous donors (found in close blood relatives) contains cells that can result in a deadly immune response against the recipient. Treatment of transfusion-associated GVHD has proved unsuccesful. It is therefore suggested that use of genetically related donors be discontinued and that unrelated donors with similar blood types be used instead. This should substantially reduce the likelihood of a transfusion reaction developing as a result of a genetically similar HLA antigen.

Analysis, Surgery, Postoperative complications, Heart, Graft versus host reaction, Graft vs. host disease, Heart surgery, column

---

Epstein-Barr virus - an old dog with new tricks

Article Abstract:

The Epstein-Barr virus (EBV) may infect and even cause smooth-muscle tumors in immunocompromised children. Two studies indicate that children with AIDS and children whose immune systems are suppressed following liver transplantation may develop smooth-muscle tumors known as leiomyomas and leiomyosarcomas. LMP1 is a cancer-causing gene that may mediate EBV-caused cell proliferation. LMP1 also prevents programmed cell death (apoptosis) by influencing the bcl-2 gene to delay apoptosis. Smooth-muscle tumors in immunosuppressed children may develop from clonal expansion of individual smooth-muscle cells infected with EBV. Such tumors may indicate a new type of latency of EBV not found before in other EBV-related malignancies. Smooth-muscle tumors in immunocompromised children may be used as models for the development of new antitumor treatments.

Editorial, Epstein-Barr virus, Leiomyosarcoma

---

Clinical outcomes after transfusion-associated hepatitis C

Article Abstract:

Patients who acquire hepatitis C from blood transfusions may become seriously ill. Researchers studied the long-term complications of 131 hepatitis C patients from 1980 to 1994. The most common initial complaints were fatigue, abdominal pain, and enlargement of the liver. The range of symptoms included 67 patients with cirrhosis, 30 patients with chronic active hepatitis, 27 patients with chronic hepatitis, and 7 patients with liver cancer. Seven additional patients developed liver cancer. Liver disease developed years after the transfusion. For example, cirrhosis was diagnosed 3 to 42 years after receiving a blood transfusion. A total of 20 patients died during the follow-up period. All but one died as a direct consequence of liver failure or liver cancer.

Hepatitis C, Hepatitis C virus

Similar abstracts:

• Abstracts: Update: West Nile virus screening of blood donations and transfusion- associated transmission-United States, 2003
• Abstracts: The Zavanelli maneuver for relief of abdominal dystocia associated with gastroschisis. Fetal protein loss in gastroschisis as an explanation of associated morbidity
• Abstracts: Current role of digitalis therapy in patients with congestive heart failure. Digitalis for treatment of congestive heart failure in patients in sinus rhythm
• Abstracts: Randomized, controlled trial of clonidine for smoking cessation in a primary care setting
• Abstracts: Cardiomyopathy of overload: a major determinant of prognosis in congestive heart failure. Clinical course and prognosis of hypertrophic cardiomyopathy in an outpatient population

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.