Transfusion associated graft versus host disease TA-GVHD) is a very rare but a fatal condition. TA-GVHH is due to the engrafment of viable T lymphocytes in the immunosupressed recipient. Very rarely it can be seen in immunocompetent patients. Premature infants, patients with either congenital or acquired immunodeficiency states, and patients receiving immunosuppressive drugs are at risk for TA-GVHD. In addition if an immunocompetent patient is heterozygous for a specific HLA locus and the donor is homozygous for the same locus, risk increases significantly. This problem mostly occurs in patients undergoing cardiac operation.

Fifty-seven years old female patient receiving 3 units of blood from his 3 sons was admitted to the hospital with widespread hyperemic macular lesions, diarrhea, fever, yellow skin color, and dark urine color. Diagnosis was TA-GVHD. Then intravenous methylprednisolon (1 g/day) and oral cyclosporin (8 mg/kg/day) were applied. But patient died without getting any benefit from the treatment.

This case was presented since it is an iatrogenic condition created by transfusion of 3 units of blood from 3 first degree relatives and the patient died.