Hemolytic reaction due to graft-versus-host (GVH) antibody production after liver transplantation from living donors: report of two cases.
Among 27 patients who received minor ABO-incompatible partial liver transplantations and 19 who received major ABO-incompatible partial liver transplantations from living donors, 2 developed hemolytic anemia within 2 weeks after transplantation. These 2 patients had received livers from their living fathers whose blood type was ABO-incompatible. B-to-A transplantation was performed in patient 1 and O-to-B transplantation was performed in patient 2. Anti-A IgM and IgG were detected in the serum of patient 1, and anti-B IgM and IgG were detected in the serum of patient 2. These antibodies were eluted from the red blood cells of the patients. The coexistence of donor-specific DNA in the peripheral blood of the patients proved that they had chimerism, and graft-versus-host antibody production due to passenger B lymphocytes in the donor's liver was subsequently confirmed.
Department of Transfusion Medicine, Kyoto University Hospital, Japan.
J
J
Kunimasa
K
K
Yurugi
K
K
Ito
Y
Y
Yamaoka
S
S
Uemoto
K
K
Tanaka
H
H
Yoshida
E
E
Maruya
H
H
Saji
S
S
Yokoyama
D000017:ABO Blood-Group System; D000743:Anemia, Hemolytic / Q000209:etiology*; D000917:Antibody Formation; D001402:B-Lymphocytes / Q000276:immunology; D002675:Child, Preschool; D004247:DNA / Q000032:analysis; D005260:Female; D006086:Graft vs Host Disease / Q000276:immunology*; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology; D007075:Immunoglobulin M / Q000276:immunology; D007223:Infant; D016031:Liver Transplantation / Q000009:adverse effects / Q000276:immunology*; D019520:Living Donors; D008297:Male
D000017:ABO Blood-Group System; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D004247:DNA