Receiving blood donated by a close relative might soon be history. If the latest research is to be believed, there is every chance of one developing Post-Transfusion Graft versus Host Disease (PT-GVHD) in such cases.

People worldwide generally opt for receiving blood donated by a close relative or family member instead of sourcing it from a blood storage unit at a hospital or blood bank. A hundred times manifold. One of the major reasons for this is the belief that a known person’s blood is safer than an unknown person’s. However, this can increase the risk of PT-GVHD from one in a hundred thousand to just one in a thousand.

The mortality rate from PT-GVHD is as high at 90-100%. Very few cases have been identified which can be classified as survivors of acute PT-GVHD. What happens in GVHD is that the host tissue rejects the transplanted one, in this case, the donor’s blood.

In PT-GVHD, donor lymphocytes in transfused blood attack recipient organs and tissues. The donor cells recognize recipient human leukocyte antigen (HLA), proliferate via lymphoblastic transformation, and are not eliminated by host immune defenses. Typical PT-GVHD presents with fever, generalized erythema 1 or 2 weeks after transfusion, followed by liver dysfunction, diarrhea, and bone marrow failure with pancytopenia. Most patients die of multi-organ failure within 1 month of transfusion.

It has been suggested that any such transfusion should be preceeded by irradiation of the blood and blood products. Transfusion of fresh blood, especially that stored for fewer than 3 days, should be avoided whenever possible, except for platelet concentrates.

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