title: Incidence and pattern of hemolytic anemia after minor ABO-mismatched living-donor lobar lung transplantation.
abstract: OBJECTIVE
  Living-donor lobar lung transplantation (LDLLT) has been successfully performed in Japan. In LDLLT, the recipient usually receives one lower lobe from each of two donors; however, finding two ABO-matched donors is often difficult. Solid organ transplants from donors with minor ABO-mismatches can be complicated by hemolysis. We investigated the incidence of de novo anti-ABO antibody production and hemolysis in patients receiving LDLLT across minor ABO-mismatches.
  
  
  METHODS
  We evaluated 23 patients who underwent LDLLT between June 2008 and December 2011, including 11 patients who underwent minor ABO-mismatched transplantation. We measured the anti-A/B antibody serum titers, hemoglobin concentrations and indirect bilirubin levels.
  
  
  RESULTS
  None of the patients showed any clinical signs of hemolytic anemia (mean follow-up period; 16 months). Two of the 11 patients (18 %) receiving minor ABO-mismatched LDLLTs showed a small amount of de novo anti-B antibodies for a transient period. These patients showed gradual progression of anemia, and weak de novo anti-A/B antibodies were detected with column agglutination technology. The patients received only 2 U of washed type O red blood cells; thereafter, the hemolytic anemia did not develop further in either case.
  
  
  CONCLUSIONS
  LDLLT across minor ABO-mismatches results in the transient appearance of weak de novo anti-A/B antibodies with a low incidence; thus, this procedure can be a safe treatment.
authors.affiliation: Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Ohsumi
authors.forename: Fengshi
authors.initials: F
authors.lastname: Chen
authors.forename: Kimiko
authors.initials: K
authors.lastname: Yurugi
authors.forename: Taira
authors.initials: T
authors.lastname: Maekawa
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Shoji
authors.forename: Masaaki
authors.initials: M
authors.lastname: Sato
authors.forename: Akihiro
authors.initials: A
authors.lastname: Aoyama
authors.forename: Toru
authors.initials: T
authors.lastname: Bando
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Date
mesh_terms: D000017:ABO Blood-Group System / Q000276:immunology; D000328:Adult; D000743:Anemia, Hemolytic / Q000453:epidemiology / Q000209:etiology*; D000917:Antibody Formation; D001787:Blood Group Incompatibility; D001989:Bronchiolitis Obliterans / Q000601:surgery; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D054988:Idiopathic Interstitial Pneumonias / Q000601:surgery; D015994:Incidence; D019520:Living Donors; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D000017:ABO Blood-Group System