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Transfüzyon ilişkili GVHH

Yıl 2023, Cilt: 32 Sayı: 2, 91 - 96, 30.06.2023
https://doi.org/10.17827/aktd.1182692

Öz

Transfüzyonun, kendisi hayat kurtaran bir tedavi olabildiği gibi, hayatı riske atabilecek komplikasyonlara da neden olduğu görüldü. Transfüzyon ilişkili graft versus host hastalığı (Ti-GVHH), kan transfüzyonları sonrasında nadir gelişen fatal bir komplikasyondur. Tİ-GVHH ilk olarak 1960’lı yıllarda ise Nispet ve Heskop tarafından, immun özelliğini koruyan lenfositlerin immun yetmezliği olan bireye verilmesi ile gelişen mortal bir hastalık olarak tanımlandı. Tİ-GVHH en sık eritrosit transfüzyonu ile ilintili bulunsa da, trombosit, granülosit ve donmamış plazma transfüzyonları ile gelişebilmektedir. Temel mekanizması, immun sistemin birincil işlevi olan kendinden ve kendinden olmayanı ayırt etme fonksiyonuna bağlı olarak gelişir. Bu riske eşlik edecek ya immunsuprese bir alıcı veya transfüze edilen kan ile parsiyel bir HLA benzerliğinin de olması gerekmektedir. Hem primer hem de sekonder immun yetmezlik durumları ile Tİ-GVHH geliştiği bilinmektedir. Parsiyel HLA benzerliği, transfüzyonda alıcı ile vericinin HLA genlerinin kismi benzerliğini ifade eder. En sık semptomları, cilt döküntüsü, ateş, hepatit, pansitopeni, diyare, kemik iliği hipoplazisi/aplazisidir. Tanısı güç olup, öncelikle şüphelenme ile başlamaktadır.Tanısı gibi tedavisi de zor bir hastalıktır. Bu yüzden replasman endikasyonunu doğru koymak gerekmektedir. Replasman yapılması planlanaması durumunda riskli hastalarda kan ürünü ışınlanması sağlanmalıdır.Diğer önleyici yöntemler,patojen inaktivasyonu, dondurma-çözdürme ve lökosit filtrasyonudur.Kesin tedavisi allojenik kemik iliği naklidir. Nakile uygun olmayan veya nakile kadarki zamanda immunsupresif ajanlarda kullanılabilemektedir

Kaynakça

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Toplam 41 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Derleme
Yazarlar

Şendağ Yaslıkaya 0000-0001-5264-8405

Sedat Biter 0000-0002-1053-0668

Merve Koba 0000-0002-2381-1530

Merve Erdoğan 0000-0002-6152-8314

Naciye Nur Tozluklu 0000-0003-2424-8898

Bektaş Işık 0000-0001-9553-722X

Semra Paydaş 0000-0003-4642-3693

Erken Görünüm Tarihi 23 Haziran 2023
Yayımlanma Tarihi 30 Haziran 2023
Kabul Tarihi 28 Nisan 2023
Yayımlandığı Sayı Yıl 2023 Cilt: 32 Sayı: 2

Kaynak Göster

AMA Yaslıkaya Ş, Biter S, Koba M, Erdoğan M, Tozluklu NN, Işık B, Paydaş S. Transfüzyon ilişkili GVHH. aktd. Haziran 2023;32(2):91-96. doi:10.17827/aktd.1182692