Nonhemolytic passenger lymphocyte syndrome: donor-derived anti-M in an M+ recipient of a multiorgan transplant.
Passenger lymphocyte syndrome (PLS) is a well-recognized complication that may follow a hematopoietic progenitor cell or solid-organ transplant. Typically, the syndrome presents as acute hemolysis of the recipient's RBCs, which have become serologically incompatible with blood group antibodies formed by passively transfused donor-origin B lymphocytes. Most cases involve anti-A or anti-B. However, there are cases involving non-ABO serologic incompatibility, as well as cases in which the serologic incompatibility was not associated with clinical evidence of hemolysis. This report describes a case of passenger lymphocyte syndrome in an M+ recipient who developed anti-M after receiving a multiorgan transplant from an M- cadaver donor. Although the temporal events and serologic findings were consistent with a diagnosis of PLS, there was no evidence of in vivo hemolysis associated with the identification of a newly formed anti-M. This report includes a literature review of other case reports of PLS associated with non-ABO antibodies in solid-organ and hematopoietic progenitor cell transplant recipients.
Department of Pathology, Georgetown University Hospital, Washington, DC 20007, USA.
A T
AT
Makuria
A
A
Langeberg
T M
TM
Fishbein
S G
SG
Sandler
D000328:Adult; D000906:Antibodies / Q000097:blood; D001787:Blood Group Incompatibility / Q000276:immunology*; D006461:Hemolysis / Q000276:immunology; D006801:Humans; D007422:Intestines / Q000637:transplantation; D016031:Liver Transplantation / Q000009:adverse effects; D008214:Lymphocytes / Q000276:immunology*; D008951:MNSs Blood-Group System / Q000276:immunology*; D008297:Male; D016377:Organ Transplantation / Q000009:adverse effects*; D016035:Pancreas Transplantation / Q000009:adverse effects; D013270:Stomach / Q000637:transplantation; D013577:Syndrome; D014019:Tissue Donors
D000906:Antibodies; D008951:MNSs Blood-Group System