gvhd - smily1

[ArchivalUser]

Can anyone expain me About it,

[ArchivalUser]

which one transplant associated GVHD or transfusion associated GVHD?

transfusion associated GVHD occurs after transfusing blood to a immunocompromised donor such as patients with leukemia, lymphoma or those post bone marrow transplant. This is because lymphocytes in donor blood attacks the recipient's tissues ...rash occurs, liver enzymes are elevated, diarrhea follows . Prevention is with using irradiated blood products. Radiating blood will kill the donor lymphocytes. ( source from dr.red hematology lecture)

[ArchivalUser]

thanx

[ArchivalUser]

wat is difference bw tansplant gvhd and transfusion gvhd

[ArchivalUser]

transplant gvhd can occur after a bone marrow transplant. The complications that occur after organ transplants like with kidney, liver etc are related to host rejecting the graft not really GVHD.
So GVHD mostly is a problem after BM transplant with a donor. (Allogeneic transplant). Autologous transplant where recipient's own stem cells are collected and transfused will not have GVHD becauise his own cells will not see his organs as foreign. But when you give donor graft, t lymphocytes present in donor bone marrow will see recipient's organs as foreign and will attack them ...that is graft versus host disease!
Prevention is with tacrolimus and methotrexate. HLA matching, using sibling donor and ABO matching will also reduce GVHD.

Acute form occurs with in first 100 days of transplant - c/f thrombocytopenia, elevated LFTs, Skin rash (maculopapular rash), abdominal pain and diarrhea, nausea and vomiting, mucosal ulcers, gi damage. If acute GI GVHD is suspected, endoscopic biopsy need to be done to confirm. Treatment steroids IV and later oral.
Chronic GVHD is more subtle. May have chronic diarhhea, skin rash and scleroderma like skin changes which you can check by extending the fingers to check for restricted moility.
Treatment prednisone

Very interesting thing is GRAFT versus Leukemia or lymphoma effect. This means GVHD to some degree is important and beneficial because GVHD will keep monitoring and will prevent host disease like leukemia from coming back. That is why Allogeneic transplants are more effective than autologous transplants in curing leukemia