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[Hemolytic anemia after kidney transplantation]
J Cartron1, S Blesson, J L Celton
1Centre de Transfusion sanguine, Hôpital Necker-Enfants Malades, Paris.
Presse Medicale (Paris, France : 1983)
|April 16, 1994
Summary
A kidney transplant recipient experienced haemolysis due to anti-D antibodies produced by donor lymphocytes. This highlights the risk of transfusion-associated antibodies in organ transplantation recipients.
Area of Science:
- Immunology
- Transplantation Medicine
- Hematology
Background:
- Haemolysis following organ transplantation is a rare but serious complication.
- Previous cases involved allospecific anti-erythrocyte antibodies.
- This study investigates a case of haemolysis after renal transplantation.
Observation:
- An 18-year-old female patient with end-stage renal failure received a kidney transplant from her father.
- The patient was O Rh positive, while the donor was O Rh negative.
- The donor had a history of receiving Rh positive blood transfusions, resulting in anti-D antibodies.
Findings:
- Post-transplantation, the patient developed haemolysis with a significant drop in hemoglobin levels.
- Anti-D antibodies were detected in the patient's serum, and direct antiglobulin test was positive.
- The patient's anti-D antibodies shared Gm allotyping with the donor's anti-D antibodies, suggesting donor-derived antibody production.
Implications:
- This case demonstrates that immunocompetent B lymphocytes transferred with the transplanted organ can produce clinically significant antibodies.
- It underscores the importance of careful donor selection and screening for antibodies, especially in Rh-incompatible transplantations.
- Managing such cases may require specific immunosuppressive strategies and close monitoring for haemolytic reactions.