Heart Rejection anti-B

Status: 
Ready to upload
Record number: 
1586
Adverse Occurrence type: 
MPHO Type: 
Estimated frequency: 
Case report
Time to detection: 
5 days
Alerting signals, symptoms, evidence of occurrence: 
Anti-B IgM antibody titer rise beginning on day 5, anti-B IgG rise beginning day 7 post heart transplant.
Demonstration of imputability or root cause: 
Frank clinical cardiac rejection in a blood group A recipient who received a group B cardiac allograft. Histologic confirmation included diffuse destruction of the microvasculature and endothelial necrosis in larger vessels, associated with neutrophilic inflammation of vessels beginning on day 5.
Imputability grade: 
3 Definite/Certain/Proven
Groups audience: 
Reference attachment: 
Suggest references: 
Pikul, F. J., Bolman, R. M., Saffitz, J. E. and Chaplin, H. (1987). Anti-B-mediated rejection of an ABO-incompatible cardiac allograft despite aggressive plasma exchange transfusion. Transplant Proc 19(6): 4601-4604.
Expert comments for publication: 
1) 1987 case report of heart from a group B donor transplanted into a group A recipient with baseline anti-B titer of 1:32. 2) Daily plasma exchanges beginning on day 5 with group AB plasma (only 3 liters in volume) failed to prevent rise in anti-B titer.