Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0018133 (graft-versus-host disease)
 18,032 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Prophylactic irradiation of blood and blood components is accepted practice in order to prevent graft-versus-host disease from infused lymphocytes. Irradiation, however, results in increased red cell potassium (K+) loss, along with other possible effects that may affect red cell function and viability. Lipid peroxidation (LP), a process initiated by the production of oxygen free radicals, is increased in red cells in the presence of reactive iron species and various heme moieties. In this report, it is noted that not only is plasma K+ significantly increased following blood irradiation, but LP is also increased compared with paired non-irradiated blood samples. Furthermore, various metal chelators significantly reduce LP in the irradiated samples. These chelators also significantly reduced the rate of cellular K+ loss during the four day 37 degrees C incubation period. This study further suggests that the addition of selected metal chelators may be effective in both irradiated and non-irradiated stored blood by improving the function and viability of transfused erythrocytes.
 ...
PMID:The effect of metal chelators on lipid peroxidation in irradiated erythrocytes. 145 32

Transfusion-associated graft-versus-host disease (TA-GVHD) may occur whenever immunologically competent allogeneic lymphocytes are transfused to an immunocompromised recipient. Irradiation of blood components eliminates the risk of TA-GVHD but may damage the cellular elements in the transfused component, particularly if the cells are stored for prolonged periods in the irradiated state. To study the effect of irradiation on long-term storage of red cells, AS-1 red cells from eight normal subjects were prepared on two occasions. On one occasion, the units were stored as standard AS-1 red cells for 42 days at 4 degrees C; on the other, they were exposed to 3000 cGy radiation within 4 hours of collection and then were stored as AS-1 red cells for 42 days at 4 degrees C. The donations were at least 12 weeks apart. Irradiated units demonstrated significant elevations in poststorage plasma hemoglobin (Hb) (623 +/- 206 vs. 429 +/- 194 g/dL [6230 +/- 2060 vs. 4290 +/- 1940 g/L], p less than 0.02) and plasma potassium (78 +/- 4 vs. 43 +/- 9 mEq/L [78 +/- 4 vs. 43 +/- 9 mmol/L], p less than 0.01) and significant decreases in red cell ATP (1.9 +/- 0.2 vs. 2.1 +/- 0.3 microM/g Hb, p less than 0.04) and 24-hour posttransfusion red cell recovery (68.5 vs. 78.4%, p less than 0.02), as compared to nonirradiated units. It can be concluded that irradiation with 3000 cGy damages red cells and that long-term storage in the irradiated state may enhance this damage. Red cells should not be stored for 42 days after irradiation with 3000 cGy.
 ...
PMID:The effect of prestorage irradiation on posttransfusion red cell survival. 150 5

A 9-year-old boy was admitted with the diagnosis of myelodysplastic syndrome (FAB RAEB in T). The patient was treated with busulfan and cyclophosphamide and transplanted with bone marrow cells from an HLA identical sister. Cyclosporin A (CyA) and short term methotrexate (MTX) was given for prophylaxis against graft versus host disease (GvHD). The serum potassium value was observed to increase to 6.3 mEq/l during the period of CyA therapy. The serum potassium value returned to 4 mEq/l when CyA treatment was decreased to a serum concentration of less than 50 ng/ml (FPIA). On day 90 post transplantation the patient was diagnosed as relapsed. The patient was preconditioned with cyclophosphamide and total body irradiation and a second bone marrow transplantation was performed using cells from the same donor. He was treated again with CyA and short term MTX for the prevention of GvHD. Once again the patient became hyperkalemic with 6.8 mEq/l. The serum creatinine level was 0.9 mg/dl, the GFR was 52.1 ml/min, FEK was 7.1%. Pseudohypoaldosteronism or hyporeninemic hypoaldosteronism was suspected. To investigate this possibility a renin/aldosterone stimulation test was performed. We speculate that an idiosyncratic response to CyA resulted in pseudohypoaldosteronism and produced a defect in potassium secretion.
 ...
PMID:[Hyperkalemia in a cyclosporine A-treated allogeneic bone marrow transplant recipient]. 154 16

A 19-year-old male, suffering from post-hepatitis aplastic anaemia, was transplanted with bone marrow cells from his HLA-identical, MLC non-reactive brother. Haematological recovery ensued, but the patient also developed grade IV graft-versus-host disease (GVHD). In addition to involvement of skin, liver and gut, the kidney seemed affected by GVHD since the patient has hypokalaemia and severe hyperkaluria. Other causes of urinary potassium loss were excluded. The amount of potassium loss correlated well with the severity of the GVH-reaction. Although coagulation disorders prohibited a kidney biopsy, the clinical course suggested GVHD to be the cause of the urinary potassium loss.
 ...
PMID:Extreme potassium loss in a patient with severe graft versus host disease. 700 82

Post-transfusion graft-versus-host disease (PT-GVHD) is a rare complication of blood transfusion. However, it occurs not only in immunosuppressed patients but also in immunocompetent patients, and is a phenomenon with a heavy mortality rate of more than 90 percent. At present, the use of blood irradiated is considered the most effective method of preventing of PT-GVHD. However, there are some unsettled problems such as the appropriate dose of irradiation, the influence of irradiation on the function of blood components, the elevation of potassium levels and the selection of patients suitable for irradiated blood transfusion.
 ...
PMID:Prevention of post-transfusion graft-versus-host disease. 792 33

Gamma irradiation of blood is performed to prevent transfusion-associated graft-versus-host disease and can result in an accelerated efflux of intracellular potassium (K+). The oxygen content of the blood and the temperature at which the irradiation is carried out are two variables reported to affect this shift; they were investigated in two separate studies. Study A-Four units of AS-5 red blood cells were each split equally into four transfer bags. One set of transfer bags was stored at 4 degrees C for 42 days (Control), the second set (IRR) was irradiated and stored. The third and fourth groups were oxygenated; the third set (+O2) was placed at 4 degrees C. The fourth set (IRR+O2) was irradiated, then stored. Supernatant K+ and hemoglobin increased in the IRR + O2 group over IRR and Control, +O2 did not rise compared to Control. Study B-Six units of CPDA-1 whole blood were each equally separated into four transfer bags. The first set of bags was placed at 4 degrees C, the second set was irradiated and then stored (IRR). The third group of bags was irradiated and given an 8-hour 22 degrees C incubation prior to storage at 4 degrees C (IRR-22). The fourth set was irradiated, placed at 37 degrees C for 2 hours, then stored. Supernatant K+ was lower during the first 7 days of storage for the IRR-22 and IRR-37 groups compared to IRR, but these increased to IRR levels by day 35. Irradiation of blood products results in an accelerated K+ shift that can be exacerbated by the presence of oxygen. The injury can be partially and temporarily corrected by a post-irradiation incubation at 22 degrees C or 37 degrees C.
 ...
PMID:Effect of oxygen and temperature on the potassium efflux of irradiated, stored red blood cells. 794 70

Gamma irradiation of blood components is used to prevent posttransfusion graft versus host disease. This process has been demonstrated to cause an increase in the permeability of the red blood cell membrane to potassium and sodium. Because of this red cell membrane lesion, it is important to investigate the effect of irradiation on the posttransfusion recovery of stored red blood cells. In the present study, the 24-hour posttransfusion recovery of AS-1 red cells irradiated with 30 Gy one or 14 days after collection and stored for a total of 35 days was compared to the recovery of unirradiated red blood cells stored for 35 days. There was no significant difference in the mean 24-hour posttransfusion recovery of 51Cr labeled red blood cells among any of the groups studied. Each group had a mean recovery > 75 percent. The mean potassium and hemoglobin concentrations at the end of 35 days of storage were significantly higher in both of the irradiated groups compared to the unirradiated group, but were not significantly different from each other. Under the conditions of this study, gamma irradiation did not significantly affect the 24-hour posttransfusion recovery of red blood cells stored for 35 days.
 ...
PMID:Effect of gamma irradiation on the in vivo recovery of stored red blood cells. 832 56

Irradiation of blood components eliminates the risk of transfusion-associated graft-versus-host disease. Freezing directed or rare red cell units that are irradiated but not transfused would facilitate inventory management and would increase the transfusion options for the involved patients. However, no studies have been performed to evaluate whether prestorage irradiation damages subsequently frozen red cells. Ten normal volunteers donated a unit of whole blood on two separate occasions. One unit was irradiated with 15 Gy (1500 rad), stored at 4 degrees C for 6 days, and then frozen and stored at -75 degrees C for 56 days. The other unit (control) was similarly stored but was not irradiated. Aliquots of the units were tested on Day 0 and Day 6 and, after deglycerolization, on Day 62. Comparison of means and changes in means showed no significant differences in red cell ATP, 2,3 DPG, or supernatant hemoglobin and glucose in control and irradiated units. The difference in the change in supernatant potassium from Day 0 to Day 6 in control and irradiated units was significant (1.5 to 28.6 mmol/L vs. 1.5 to 48.5 mmol/L: p < 0.0001). Irradiation did not cause significant differences in postdeglycerolization red cell recovery (control, 84.5% vs. irradiated, 81.2%) or in 24-hour posttransfusion autologous red cell survival (control, 91.1% vs. irradiated, 90.9%). Red cells can be irradiated, stored at 4 degrees C for 6 days, and subsequently frozen with no increase in detectable damage as compared to controls that were not irradiated.
 ...
PMID:Characteristics of red cells irradiated and subsequently frozen for long-term storage. 848 41

Ionizing radiation is currently used for prevention of transfusion associated graft versus host disease (TAGVHD). As radiation damage is associated with the production of activated oxygen species, the aim of this study was to observe the immediate effect of ionizing radiation on red cell membrane and intracellular oxidative defense systems. Neonatal and iron deficiency (IDA) cells, known for their increased sensitivity to oxidative stress, were chosen and compared with normal cells. Irradiation was performed in doses of 1500 cGy, 3000 cGy and 5000 cGy. GSH and methemoglobin levels and the activity of different antioxidant enzymes, measured under optimal in vitro conditions, were preserved in all cells after irradiation. Only radiation at the highest does of 5000 cGy, caused significant potassium leakage in neonatal cells and insignificant increase in IDA cells. Thus, cells with increased sensitivity to oxidative stress are more susceptible to damage by ionizing radiation than normal cells.
 ...
PMID:Effect of radiation on red cell membrane and intracellular oxidative defense systems. 872 21

Transfusion-associated graft-versus-host disease is a rare but usually fatal complication of transfusion of cellular blood components, caused by multiorgan engraftment and proliferation of donor T lymphocytes. The classical features of skin rash, diarrhoea and hepatitis, along with striking bone-marrow failure, are seen 1-2 weeks after transfusion. Although early reports described the condition only in immunosuppressed individuals, sharing of an HLA haplotype between donor and an immunocompetent recipient can also result in transfusion-associated graft-versus-host disease. The condition is entirely preventable by gamma irradiation of cellular blood components to 25 Gy, although this results in some reduction of red-cell viability and increased loss of red-cell potassium. The major indications for irradiated blood components include bone marrow/stem cell auto- or allografting, Hodgkin's disease, intrauterine transfusions, and transfusions from relatives or HLA-selected platelet donors.
 ...
PMID:Transfusion-associated graft-versus-host disease and its prevention. 883


1 2 3 Next >>