title: Severe haemolysis after an ABO unmatched kidney transplant - a nonsecretor transplanted from a donor with high anti-A titre.
abstract: A case of severe haemolysis following an ABO unmatched renal transplant is reported in a group A nonsecretor who received a kidney from a group O living related donor. Following the haemolytic episode, group A donor units were incompatible and the patient was transfused with group O blood. Serological investigation of the recipient revealed anti-A present in the serum and on the red cells. Investigation of the donor revealed the presence of high-titre anti-A. The association of such high-titre donor antibody with haemolysis in ABO unmatched grafts has not been reported before. We discuss the risk factors for developing haemolysis in an ABO unmatched organ transplant and explore the possible relevance of such high donor antibody titre to recipients who are nonsecretors.
authors.affiliation: Department of Haematology, John Radcliffe Hospital, Headington, Oxford; Department of Surgery, Renal Transplant Unit, Churchill Hospital, Headington, Oxford, UK. alex@csternberg.freeserve.co.uk
authors.forename: A J
authors.initials: AJ
authors.lastname: Sternberg
authors.forename: G
authors.initials: G
authors.lastname: Lee
authors.forename: T
authors.initials: T
authors.lastname: Croxton
authors.forename: N
authors.initials: N
authors.lastname: Mundy
authors.forename: P
authors.initials: P
authors.lastname: Morris
authors.forename: T J
authors.initials: TJ
authors.lastname: Littlewood
authors.forename: M F
authors.initials: MF
authors.lastname: Murphy
mesh_terms: D000017:ABO Blood-Group System / Q000276:immunology*; D000328:Adult; D006461:Hemolysis / Q000276:immunology*; D006650:Histocompatibility Testing; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D014181:Transplantation Immunology; D014184:Transplantation, Homologous
chemical_list: D000017:ABO Blood-Group System