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Immune-mediated hemolytic anemia in children after liver and small bowel transplantation

Piotr Czubkowski1, Mike Williams, Seema Bagia

  • 1Liver Unit, Birmingham Children's Hospital, National Health Service Foundation Trust, Birmingham, United Kingdom.

Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
|April 8, 2011
PubMed

Four children who underwent ABO-compatible combined liver and small bowel transplantation developed severe immune-mediated hemolytic anemia. The main management strategies were early and aggressive treatment with steroids, the introduction of rituximab (an anti-CD20 monoclonal antibody), and the use of plasma exchange together with compatible but minimal blood transfusions. Three of the 4 children developed thrombi in the major vessels. In small bowel transplant patients, the early recognition of hemolytic anemia and intensified management with anticoagulation are necessary for the prevention of this complication.

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