Korean J Hepatol > Volume 5(2); 1999 > Article
The Korean Journal of Hepatology 1999;5(2): 162-167.
ABO 불일치 간이식 후 발생한 Passenger Lymphocyte Syndrome 1예 ( A Case of Passenger Lymphocyte Syndrome in a ABO-unmatched Liver Transplant Patient )
A Case of Passenger Lymphocyte Syndrome in a ABO-unmatched Liver Transplant Patient
Dong Kyun Park, M.D., Sun Suk Kim, M.D., Hyun Chul Park, M.D., Duck Joo Choi, M.D., Dong Hoon Kang, M.D., You Kyoung Kim, M.D., Jong Jae Park, M.D., Joung Nam Lee, M.D.*, Ill Hae Seo, M.D.†and Ju Hyun Kim, M.D.
Department of Internal Medicine , General Surgery*, Clincial Pathology† Gachon Collage of Medicine, Inchon, Korea
ABSTRACT
Transplantation of ABO-unmatched solid organs has been associated with the development of immune hemolysis due to donor-derived antibodies produced by passenger lymphocytes in the graft, called "Passenger Lymphocyte Syndrome". In a liver transplantation, about 40% of patients at risk has detectable donor-derived antibodies and hemolytic anemia occurs in 29% of patients. It is characterized by hemoglobinemia, a rapid fall in hemoglobin, hyperbilirubinemia, and an excessive red cell transfusion requirement occurring 1 to 3 weeks after the transplantation. These clinical findings are accompanied by the laboratory findings of a positive direct antiglobulin test and the detection of unexpected antibodies in the patients' red cell eluate and serum. Both the hemolytic anemia and serology resolve over the course of weeks to months. To the best of our knowledge, this is the first case of hemolytic anemia due to passenger lymphocyte syndrome after ABO-unmatched liver transplantation in Korea. (Korean J Hepatol 1999;5:162-167)
KeyWords: ABO-unmatched liver transplantation, Hemolytic anemia, Passenger lymphocyte syndrome, Direct antiglobulin test
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