Donor anti-Jk(a) causing hemolysis in a liver transplant recipient.

TitleDonor anti-Jk(a) causing hemolysis in a liver transplant recipient.
Publication TypeJournal Article
Year of Publication2002
AuthorsHareuveni M, Merchav H, Austerlitz N, Rahimi-Levene N, Ben-Tal O, Rahimi-Leveen N
Pagination363 - 7
Date Published2002
ISBN Number0041-1132
Other Numberswdn, 0417360
Keywords*Hemolysis/im [Immunology], *Kidd Blood-Group System/im [Immunology], *Liver Transplantation, *Lymphocytes/im [Immunology], *Tissue Donors, ABO Blood-Group System/im [Immunology], Adult, Anemia, Hemolytic/im [Immunology], Blood Group Incompatibility/im [Immunology], Blood Grouping and Crossmatching, Blood Transfusion, Erythrocytes/im [Immunology], Humans, Immunosuppressive Agents/tu [Therapeutic Use], Isoantibodies/bl [Blood], Male

BACKGROUND: Hemolytic transfusion reactions have been observed in recipients of ABO- and/or D-mismatched marrow, peripheral blood, and solid organs. Passenger lymphocyte syndrome occurs when immunocompetent donor lymphocytes transferred during transplantation produce alloantibodies against host antigens., CASE REPORT: The first case of a delayed, anti-Jk(a)-mediated hemolytic reaction in a liver transplant recipient, caused by passenger donor lymphocytes, is reported here. A 43-year-old man underwent liver transplantation. Six weeks later, the patient underwent a second liver transplant. On Day 10 of the second transplant, clinical hemolysis ensued; anti-Jk(a) was detected. The patient's DAT became positive, and anti-Jk(a) was eluted from his RBCs. On Day 35 of the patient's second transplant, 3 weeks after the last blood transfusion, the patients' DAT was still weakly positive with anti-Jk(a) in the eluate. Six months later, serum antibody screening was negative, but the DAT was still weakly positive. The patient's RBCs tested Jk(a+), whereas the second donor's RBCs were Jk(a-)., CONCLUSION: This is the first documentation of clinically significant hemolysis caused by anti-Jk(a), produced by passenger lymphocytes transferred from the donor's liver to the transplant recipient.

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