Passenger Lymphocyte Syndrome after Renal Transplant: Case Report

Passenger lymphocyte syndrome (PLS) is a rare cause of anemia resulting from immune-mediated hemolysis in the post-transplant recipient. We report a case of 26-year-old male who underwent renal transplant. His mother as donor was O positive while he was A positive. He developed anemia at 1-week post-transplant, which later turned out to be PLS. Laboratory findings included rapidly decreasing Hb level and intravascular hemolysis. Hemolysis was brief, because the lymphocytes passed on with the donor organ were able to proliferate only for a while. The case signifies the importance of PLS as a cause for anemia, specifically in the early period after solid organ transplant. It is usually self-limiting, and the treatment requires blood transfusion of donor's blood group.