A 'dangerous' group O donor: severe hemolysis in all recipients of organs from a donor with multiple red cell alloantibodies.

TitleA 'dangerous' group O donor: severe hemolysis in all recipients of organs from a donor with multiple red cell alloantibodies.
Publication TypeJournal Article
Year of Publication2008
AuthorsShortt J, Westall GP, Roxby D, Chen JW, Snell GI, Polizzotto MN, Magrin G, Webb A, Street AM, Borosak M, Wood EM, Cole-Sinclair MF
JournalAmerican journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons//Am J Transplant
Volume8
Issue3
Pagination711 - 4
Date Published2008
ISBN Number1600-6143
Other Numbers100968638
Keywords*ABO Blood-Group System/im [Immunology], *Erythrocytes/im [Immunology], *Hemolysis/im [Immunology], *Isoantibodies/im [Immunology], *Liver Transplantation/ae [Adverse Effects], *Lung Transplantation/ae [Adverse Effects], Blood Group Incompatibility/im [Immunology], Female, Humans, Isoantibodies/an [Analysis], Lymphocytes/im [Immunology], Male, Middle Aged, Syndrome, Tissue Donors
Abstract

Alloimmune hemolysis is a recognized but infrequent complication of solid organ transplantation, particularly where there is incompatibility within the ABO blood group system. We describe severe hemolysis due to passenger lymphocyte syndrome (PLS) in all three recipients of organs from a single donor with multiple red cell (RC) alloantibodies. The first patient, a liver transplant recipient, required augmentation of immunosuppression to treat immune hemolysis due to anti-B, -D, -C and -Cellano (k). This is the first description of PLS caused by alloantibody to the high incidence RC antigen, k. The two single lung transplant recipients developed hemolysis due to anti-D. Both required escalation of immunosuppression and early transfusion support. Three months posttransplant, all three patients have ongoing evidence of compensated hemolysis. This series highlights the potential for severe non-ABO-mediated immune hemolysis following solid organ transplantation. A positive donor RC antibody screen should prompt careful monitoring of organ recipients for hemolysis.

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