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In Vitro and In Vivo Assessment of T, B and Myeloid Cells Suppressive Activity and Humoral Responses from Transplant Recipients
Published on: August 12, 2017
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Passenger lymphocyte syndrome after solid organ transplantation: Laboratory perspective
Han Joo Kim1, Hee-Jeong Youk2, Hyo Jin Kim1
1Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Summary
Passenger lymphocyte syndrome (PLS) is a rare cause of post-transplant hemolysis linked to minor blood group incompatibilities. Early detection often relies on blood bank findings, emphasizing lab-clinical communication for management.
Area of Science:
- Transplantation Immunology
- Hematology
- Blood Banking
Background:
- Passenger lymphocyte syndrome (PLS) is an uncommon complication following organ transplantation.
- It is typically associated with minor ABO or RhD incompatibilities between donor and recipient.
- PLS can lead to post-transplant hemolysis and complicate transfusion support, often being underrecognized.
Purpose of the Study:
- To retrospectively review and characterize cases of passenger lymphocyte syndrome (PLS).
- To identify diagnostic patterns and clinical features of PLS in a tertiary care setting.
- To emphasize the role of the blood bank laboratory in PLS detection.
Main Methods:
- Retrospective review of PLS cases from January 2012 to December 2021.
- Case identification based on minor ABO/RhD incompatibility, positive direct antiglobulin test (DAT), donor-derived alloantibodies, and exclusion of other hemolysis causes.
- Analysis of clinical, laboratory, transfusion data, and antibody persistence.
Main Results:
- Eleven cases of PLS were identified across liver, kidney, and lung transplants.
- All cases occurred post-minor ABO or RhD incompatible transplantation in recipients needing transfusions.
- Donor blood groups were predominantly O positive; DAT positivity was common, typically resolving within 9-21 days.
Conclusions:
- Passenger lymphocyte syndrome can be detected from a blood bank laboratory perspective, often without overt clinical suspicion.
- Effective communication and information sharing between clinical teams and laboratories are crucial.
- Timely recognition and appropriate management of PLS are essential for patient care.
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