[Institution and significance of the new guidelines for prevention of transfusion associated graft versus host disease]

Abstract

The Japanese Society of Blood Transfusion (JSBT) has produced guidelines three times for preventing transfusion associated graft versus host disease (TA-GVHD). On January 1, 1992, the first guidelines from JSBT were issued after the recognition that immunocompetent patients had suffered from TA-GVHD after surgery. These guidelines were established to provide protective irradiation for transfusion with cardiosurgery, the same as for transfusions with congenital immunodeficiency, infants, and other immunocompromised patients, as well as exchange transfusions of newborn. In 1993, the Japanese Red Cross analysed the data from questionnaires about TA-GVHD from hospitals in Japan, and it was revealed that the majority of the patients were transfused for cardiac surgery and surgery for cancers. On May 12, 1995, the second set of guidelines was issued, indicating that transfusions accompanying cancer surgery should be protected by irradiation, and that blood for transfusion should be irradiated within 72 hours after donation. In April 1996, the Japanese Ministry of Health and Welfare issued an urgent warning about TA-GVHD, because a report from the Japan Red Cross Blood Center stated that about ten patients still died yearly from TA-GVHD in the last few years. JSBT organized a subcommittee for preventing TA-GVHD, and issued the third version of guidelines for blood irradiation for its prevention in Japan.