Abstract
Postoperative erythroderma is a very rare but fatal syndrome following major surgeries. This syndrome is characterized by systemic erythromatous skin eruptions and multi-organ failures. We described three cases of this syndrome, and all patients received fresh whole blood perioperatively. With various signs and symptoms, all died in 2 to 4weeks postoperatively. The types of human leukocyte antigen (HLA) were studied in one case. The results revealed an alteration between the 16th and the 17th postoperative day. The types on the 17th day were identical to those of one blood donor. This alteration confirmed that the immunopathologic etiology of this syndrome was graft versus host reaction (GVHR) due to blood tranfusion. Two factors appeared to be essential for this syndrome: (1) identical HLA haplotype in the host and the graft, (2) depression of the immunological defence mechanisms of the host due to operation, use of the extracorporeal circulation, or drugs administered periperatively.
