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Adverse Occurrence type:
Time to detection:
Alerting signals, symptoms, evidence of occurrence:
Low levels platelet counts in the recipient. The transmission of B lymphocytes from the organ donor to the liver-transplant recipient and the capacity of these cells to function to the detriment of the recipient define this case as a variant of graft-versus-host disease.
Demonstration of imputability or root cause:
The clinical and laboratory findings in our patient strongly suggest that postoperative thrombocytopenia resulted from the passive transfer of idiopathic (autoimmune) thrombocytopenic purpura with the first liver transplant. The most likely mechanism to account for this phenomenon is the transfer of autoantibody-producing donor lymphocytes in sufficient number to cause autoantibody to accumulate in the recipient.
Suggest new keywords:
Thrombocytopenia, idiopathic, antibodies, liver transplantation
Friend, PJ, et al, 1990. Transmission of idiopathic (autoimmune) thrombocytopenic purpura by liver transplantation. N Eng J Med 323:807-11.