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Updated: Aug 22, 2026
Murine Kidney Transplant Technique
Published on: October 20, 2015
Absence of hemolysis after a kidney transplant in an E+ recipient from a donor with anti-E
M C Zago-Novaretti1, C R Jorge, E Jens
1Division of Immunohematology, Fundação Pró-Sangue/ Hemocentro de São Paulo, Hematology and Hemotherapy Dept., University of São Paulo Medical School, São Paulo, Brazil.
Insights
A kidney transplant was performed between a mother and her son. Despite the mother having anti-E antibodies, no hemolysis occurred in the recipient, indicating successful transplantation without complications.
Area of Science:
- Immunology
- Nephrology
- Transplantation
Background:
- Kidney transplantation is a common treatment for end-stage renal disease.
- Alloimmunization, particularly against red blood cell antigens, can complicate transplantation.
- The Rh E antigen is a significant immunogen in transfusion and transplantation settings.
Purpose of the Study:
- To report a case of kidney transplantation from a mother with anti-E antibodies to her son.
- To evaluate the risk of hemolysis in the recipient due to maternal anti-E antibodies.
- To assess the immunogenicity of transplanted lymphocytes in the context of pre-existing antibodies.
Main Methods:
- Serological testing of donor and recipient blood groups and antibody screening.
- Monitoring for clinical and laboratory signs of hemolysis post-transplant.
- Post-transplant antibody screening at multiple time points.
Main Results:
- The donor was Rh E-negative, and the recipient was Rh E-positive.
- The mother had pre-existing anti-E IgG1 antibodies.
- No clinical or laboratory evidence of hemolysis was observed in the recipient up to 6 months post-transplant.
Conclusions:
- Maternal anti-E antibodies did not cause hemolysis in the Rh E-positive recipient during kidney transplantation.
- Transplanted lymphocytes did not appear to synthesize detectable levels of anti-E antibodies.
- This case suggests a low risk of hemolysis in similar Rh-incompatible kidney transplant scenarios when the donor organ is Rh E-negative.
Abstract:
A 12-year-old Caucasian male with cystinosis received a kidney from his mother, whose red blood cells typed as group O, D+, E-. Her serum contained an anti-E with an IgG1 titer of 16 (score 31). The recipient's type was group O, D+, E+, with a negative antibody screen in the pretransplant period. The recipient and donor Rh phenotypes were most likely DCcEe and Dccee, respectively. Because the recipient's mother had no transfusion history, she was probably immunized by the fetal red blood cells of her one pregnancy (the recipient). The kidney had been immediately perfused with saline after removal from the donor. No acute or delayed hemolysis was observed clinically or in laboratory tests performed immediately after the transplant and at 7, 15, and 30 days after the transplant. Antibody screens were still negative at 6 months. In this case, anti-E was not present in the transplanted kidney in sufficient concentration to cause hemolysis of the recipient's red blood cells and transplanted lymphocytes did not synthesize sufficient anti-E to be detectable or to cause hemolysis.
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