The Role of Blood from HLA-Homozygous Donors in Fatal Transfusion-Associated Graft-versus-Host Disease after Open-Heart Surgery

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Abstract
Acute graft-versus-host disease has been described in immunocompromised patients receiving nonirradiated blood products.1 2 3 In addition to the involvement of the skin, liver, and gut typically seen in graft-versus-host disease after bone marrow transplantation,4 these patients have bone marrow involvement that results in pancytopenia. The aplasia observed in graft-versus-host disease is presumably due to recognition by the donor's immune-reactive cells of histoincompatible antigens on the host's hematopoietic precursor cells. Transfusion-associated graft-versus-host disease carries a high mortality rate; most patients succumb to infection.2 Because the onset of transfusion-associated graft-versus-host disease is delayed and because its symptoms are similar to those seen in . . .