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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
[Serological Characteristics and Transfusion of Passenger Lymphocyte Syndrome with Multiple Antibodies after Liver
Yue-Rong Wei1,2, Hui-Ni Huang2, Yun-Long Wang3
1Department of Clinical Laboratory of The First Affiliated Hospital of Guangxi Medical University/Guangxi University Key Laboratory of Clinical Laboratory Diagnostics, Nanning 530021, Guangxi Zhuang Autonomous Region, China.
Objective:
To explore the clinical features, serological test, and blood transfusion protocols of hemolytic anemia caused by passenger lymphocyte syndrome (PLS) with multiple antibodies after ABO-incompatible liver transplantation.
Methods:
The hemoglobin (Hb) and bilirubin levels were monitored in a patient (O blood type donor to B blood type) post-liver transplantation in our hospital. The ABO blood group typing, unexpected antibody screening and identify test, direct anti-globulin test (DAT) and acid elution test were performed respectively in blood samples of the patient to identify the serum and erythrocyte membrane sensitized antibodies.
Results:
The patient's Hb showed a decreasing trend on the day 6 post-operation, reaching the lowest level of 37 g/L on day 12, while her serum bilirubin increased. The patient's ABO blood group did not match. The DAT and the irregular antibody screening test were positive. Anti-B, anti-E, anti-Jkb, and anti-Mur antibodies were detected in the serum, and the anti-B antibodies were detected in the elution liquid. After intermittent infusion of 9 U O type washed red blood cells after day 12, the Hb level increased steadily but the bilirubin level decreased gradually. The patient was discharged with improved conditions on day 38 after surgery.
Conclusion:
For patients undergoing ABO-incompatible liver transplantation, monitoring the Hb, blood type antibodies, and DAT is essential to timely diagnose PLS and adjust the treatment plan including transfusion strategy.
