Joined by my new “Ask the BBGuy” co-host, Dr. Heidi Shafi from Kaiser Permanente Los Angeles, I take a detailed look at Transfusion-associated Graft-vs-Host Disease (TA-GVHD). This transfusion complication is by far one of the most dangerous, fatal in over 90% of cases. Blood bankers have known about TA-GVHD for many, many years, and most of us thought we had a pretty good idea of why it occurred. However, a paper from July 2015 (see below for reference) summarizing all of the published reports of this deadly complication makes us wonder if we really do understand this devastating complication as well as we believed. In this episode, I start from the basics and outline the details of TA-GVHD, and discuss the implications of the information found in the review mentioned above.
Note that I don’t discuss the details of irradiation that much in this episode. For more on irradiation and how it works, please see the “Ten Minute Tutorial” on irradiation available in the “Education” section.
Use the player above to listen to Episode 013 of the BBGuy Essentials Podcast!
DISCLAIMER: The opinions expressed on this episode are those of my guest and I alone, and do not reflect those of the organizations with which either of us is affiliated. Neither Dr. Shafi nor I have any relevant financial disclosures.
- 01:40: Meet the new co-host, Dr. Heidi Shafi!
- 05:15: The “Ask BBGuy” Question for this episode
- 06:45: What is “graft-versus-host disease?”
- 08:20: Requirements for GVHD
- 12:25: TA-GVHD: How is it different from “regular” GVHD?
- 22:08: Normal interactions between transfused and host T-lymphocytes (Soldiers and Pac-men)
- 25:20: What goes wrong in TA-GVHD?
- 31:25: Who is at-risk for TA-GVHD?
- 45:10: Other categories potentially at-risk
- 50:15: TA-GVHD treatment and grim prognosis
- 53:05: What’s the deal with irradiation?
- 56:05: Irradiation changes to product expiration time
- 57:20: Which products need irradiation?
- 58:55: Why isn’t leukocyte reduction enough?
- 61:30: Pathogen reduction benefit for preventing TA-GVHD
- 62:45: Discussion of Kopolovic article listed below