Living donor liver transplantation in a recipient with anti-Fy(a) and Jk(a) antibodies.
We report a case of a living donor liver transplantation using right lobe graft to a recipient having anti-Fy(a) and Jk(a) antibodies. The red blood cell (RBC) antigens of the donor were Fy (a+) and Jk (a-). We attempted to eliminate donor RBCs remaining in the graft by perfusing histidine-tryptophan-ketoglutarate. Further, Fy (a-)/Jk (a-) RBC concentrates were transfused during the operation. However, the anti-Fy(a) titer increased approximately 8-fold on the seventh postoperative day. On the same day, serum levels of transaminase and total bilirubin increased presumably due to acute cellular rejection. Steroid administration immediately reduced levels of transaminase, total bilirubin and anti-Fy(a) titer. The increase of anti-Fy(a) titer may be due to a secondary immune response to the donor's Fy(a) antigen on RBCs remaining in the graft.
Kaibori
Masaki
M
Department of Surgery, Kansai Medical University, Moriguchi, Osaka, Japan. kaibori@takii.kmu.ac.jp
Kishimoto
Yuji
Y
Yanagida
Hidesuke
H
Yokoigawa
Norio
N
Yamamoto
Hidekazu
H
Kitade
Hiroaki
H
Fukuhara
Shirou
S
Egawa
Hiroto
H
Tanaka
Koichi
K
Kamiyama
Yasuo
Y
D001663:Bilirubin / Q000097:blood; D001789:Blood Group Antigens / Q000276:immunology*; D004375:Duffy Blood-Group System / Q000276:immunology*; D017707:Erythrocyte Transfusion; D006801:Humans; D007518:Isoantibodies / Q000097:blood*; D008103:Liver Cirrhosis / Q000276:immunology* / Q000601:surgery*; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011300:Preoperative Care; D011956:Receptors, Cell Surface / Q000276:immunology*; D013997:Time Factors; D000637:Transaminases / Q000097:blood
C473745:ACKR1 protein, human; D001789:Blood Group Antigens; D004375:Duffy Blood-Group System; D007518:Isoantibodies; D011956:Receptors, Cell Surface; D000637:Transaminases; D001663:Bilirubin