Status:
Ready to upload
Record number:
1166
Adverse Occurrence type:
MPHO Type:
Estimated frequency:
Passenger lymphocyte syndrome–associated antibodies are detected relatively frequently. The resultant antibody-induced hemolysis is a well-recognized consequence in ABO-mismatched solid organ transplants, occurring in 9% of kidney, 29% of liver and 70% of heart-lung transplants. However, in patients with ABO-compatible transplants, PLS-mediated hemolysis due to Rh-incompatible antibodies is exceedingly rare.
Time to detection:
12 days
Alerting signals, symptoms, evidence of occurrence:
Hemoglobin abruptly decreased in an ABO-matched renal allograft recipient on postoperative day 12. The recipient's blood type was A Rh(D) positive; and the donor, who had been previously alloimmunized, was A Rh(D) negative.
Demonstration of imputability or root cause:
A newly positive direct antiglobulin test and anti-D antibodies in the plasma.
Imputability grade:
2 Probable
Groups audience:
Keywords:
Suggest new keywords:
Rh immunization
"passenger lymphocyte syndrome, ABO-matched renal allograft recipient", DAT (direct antiglobulin test), Delayed hemolytic transfusion reaction
Reference attachment:
Suggest references:
Craig D. Ainsworth, Mark A. Crowther, Darin Treleaven, Denise Evanovitch, Kathryn E. Webert, and Morris A. BlajchmanAinsworth, CD, Et al, 2009 Severe Hemolytic Anemia Post–Renal Transplantation Produced by Donor Anti-D Passenger Lymphocytes: Case Report and Literature Review .Transfus Med Rev 23:155-9.
Expert comments for publication:
Ainsworth, et. al provides nice Table of reported anti-D related hemolytic events