Lack of alloimmunization to D antigen in D-negative immunosuppressed liver transplant recipients.
BACKGROUND
Orthotopic liver transplantation (OLT) sometimes requires large amounts of blood. An adequate supply of Rh-negative blood for Rh-negative patients is not always available.


METHODS
Seventeen Rh-negative patients, out of 327 receiving OLT in this hospital, received from 5 to 41 units of Rh-positive red cells during surgery. Each of the 17 patients was followed for 7 weeks to 70 months after OLT for detection of unexpected antibodies. Cyclosporin A and prednisone, azathioprine, and adjunctive rabbit antilymphocyte globulin or monoclonal OKT3 antibody were used to prevent graft rejection.


RESULTS
Evidence of immunization, either to D or to antigens in the rest of the red cell antigen systems, did not appear in any patients.


CONCLUSIONS
It is hypothesized that cyclosporin A affects the immune humoral response, inhibiting lymphocyte activation and the primary immune response; consequently, Rh-positive blood may be transfused to Rh-negative OLT recipients so treated with little or no risk of alloimmunization.
Casanueva
M
M
Blood Bank Section, University Hospital, Madrid, Spain.
Valdes
M D
MD
Ribera
M C
MC
D000328:Adult; D003298:Coombs Test; D016572:Cyclosporine / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016031:Liver Transplantation / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D012203:Rh Isoimmunization / Q000276:immunology* / Q000517:prevention & control*
D007166:Immunosuppressive Agents; D016572:Cyclosporine