Delayed hemolysis resulting from anti-A1 after liver transplantation.
The authors report a case of a delayed hemolytic transfusion reaction in a type A2 recipient of a type O liver allograft. An anti-A1 antibody reactive at 37 degrees C in the indirect antiglobulin test was identified both in the patient's serum and in an eluate. Hemolysis secondary to the production of anti-A1 has been reported to be extremely rare. The English-language literature has six cases before 1979. During the 1980s, an additional seven cases were reported; six involved transplantation of a solid organ, and in each such case the donor was type O and the recipient was type A1 or A2. Recommendations regarding transfusion practice in such cases are made. An association among the transplantation of a type O organ to a type A recipient, the use of cyclosporine, and an apparent increase in the occurrence of clinically significant anti-A1 is suggested.
Brecher
M E
ME
Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota 55905.
Moore
S B
SB
Reisner
R K
RK
Rakela
J
J
Krom
R A
RA
D001323:Autoantibodies / Q000096:biosynthesis / Q000502:physiology*; D005260:Female; D006461:Hemolysis; D006801:Humans; D016031:Liver Transplantation; D008875:Middle Aged; D013997:Time Factors
D001323:Autoantibodies