Immune haemolysis in a renal transplant recipient due to antibodies with anti-c specificity

A 55-year-old man received a cadaver kidney from a donor whose serum contained red cell antibodies with anti-c specificity. Atypical antibodies were shown to be absent from the recipient's red cells and serum at the time of transplant. Blood was not transfused during surgery. Two weeks after the transplant, the recipient developed a positive direct antiglobulin test due to antibodies with anti-c specificity. Immune haemolysis was diagnosed in the patient 3 weeks after transplant. The possible mechanisms involved in antibody formation in the recipient are discussed.