From the Research
Graft-versus-host disease (GVHD) does not occur after joint replacement surgery. GVHD is a complication that happens when donor immune cells attack the recipient's tissues, but this only occurs with transplants containing living immune cells such as bone marrow, stem cell, or solid organ transplants 1. Joint replacements use artificial materials like metal, plastic, or ceramic components that don't contain living cells capable of mounting an immune response. The immune reactions that can occur after joint replacement are different - they include rejection of the prosthesis, allergic reactions to the implant materials (particularly metal sensitivity), or infection, but these are not GVHD.
Key Points to Consider
- GVHD is a major complication of allogeneic hematopoietic stem cell transplantation (HSCT) and solid organ transplantation 2, 1.
- The pathophysiology of GVHD involves the interaction between donor immune cells and the recipient's tissues, leading to an immune response against the host 3, 4.
- Joint replacement surgery uses inert materials that do not contain living cells, and therefore cannot trigger a GVHD response 1.
- Patients undergoing joint replacement should be aware of potential complications like infection, loosening, or wear of the prosthesis, but GVHD is not a concern with these procedures.
Clinical Implications
- Clinicians should be aware of the differences between GVHD and other immune reactions that can occur after joint replacement surgery.
- The risk factors for GVHD, such as African-American race, sexual and HLA mismatching, and cytomegalovirus infection, are not relevant to joint replacement surgery 2.
- The treatment strategies for GVHD, such as corticosteroids and sirolimus monotherapy, are not applicable to joint replacement surgery 2.