{"id":30870,"date":"2022-12-16T16:05:19","date_gmt":"2022-12-16T17:05:19","guid":{"rendered":"https:\/\/peymantaeidi.net\/stem-cell\/?p=30870"},"modified":"2022-12-16T18:00:16","modified_gmt":"2022-12-16T18:00:16","slug":"she-hulk-an-incredible-case-of-transfusion-associated-graft-versus-host-disease","status":"publish","type":"post","link":"https:\/\/peymantaeidi.net\/stem-cell\/2022\/12\/16\/she-hulk-an-incredible-case-of-transfusion-associated-graft-versus-host-disease\/","title":{"rendered":"She-Hulk: an incredible case of transfusion associated graft versus host disease"},"content":{"rendered":"
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  1. Neil A Barrett<\/span>, consultant paediatric haematologist<\/span>1<\/a><\/li>\n<\/ol>\n
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      1<\/sup>Children\u2019s Health Ireland\u2014Department of Haematology, Dublin, Ireland<\/address>\n<\/li>\n<\/ol>\n
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      1. neil.barrett{at}olchc.ie<\/span><\/span><\/li>\n<\/ol>\n<\/div>\n
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        Neil Barrett<\/strong> discusses the unusual haematological implications of accidental transfusion from a close relative in the high profile case of the She-Hulk, barriers to future research, and the real heroes in this<\/p>\n<\/div>\n

        Transfusion associated graft versus host disease (TaGVHD) is a rare complication of blood transfusion in which viable lymphocytes within a blood product engraft (survive and proliferate) in a recipient. This process results in an almost always fatal form of graft versus host disease,1<\/a> with donor T cells attacking multiple organs, notably the skin, liver, gastrointestinal tract, and bone marrow.<\/p>\n

        This paper analyses a high profile case of non-lethal TaGVHD due to inadvertent blood contamination of an open wound after a car accident.2<\/a> While both donor and recipient survived the crash and contamination, the recipient was left with unexpected side effects, namely inheriting the ability of the donor to transform into an enormous green rage monster.<\/p>\n

        The celebrity nature of this case means that the identities of both donor and recipient as well as the details of the incident are already in the public domain. The donor is Bruce Banner MD, PhD, PhD, PhD, PhD, PhD, PhD, PhD,3<\/a> otherwise known as the strongest Avenger.4<\/a> The recipient is Jennifer Walters, JD\u2014also known as She-Hulk2<\/a> of high profile law firm Goodman, Lieber, Kurtzberg, and Holliway, the only legal firm in the world representing superhuman clients. Walters recently made headlines after a trademark dispute with Instagrammer Titania, and as such, no details of the case are confidential.<\/p>\n

        This paper describes the risk factors for TaGVHD present in this case, discusses additional haematological phenomena that might be occurring, and suggests further research aims that might advance our understanding of transfusion medicine.<\/p>\n

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        Risk factors for TaGVHD present in the case<\/h2>\n
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        Shared genetic makeup<\/h3>\n

        The donor has revealed that he and the recipient, his first cousin, share rare combination genetic factors that allow them to synthesise \u03b3 radiation.2<\/a> They might also share HLA haplotypes. Among the risk factors for TaGVHD (box 1<\/a>), one is partial HLA similarity between the donor and host, because HLA similarity could give donor T cells an increased ability to avoid the host immune system and engraft.5<\/a> For this reason (among many others), blood donations from one family member to another (eg, parent to child) are often strongly discouraged.6<\/a><\/p>\n

        Box 1<\/span> <\/p>\n

        Risk factors for TaGVHD and indications for blood product irradiation<\/h3>\n
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        Immunocompromised host<\/h4>\n