Status:
Ready to upload
Record number:
1172
Adverse Occurrence type:
MPHO Type:
Time to detection:
0 - 13 days
Alerting signals, symptoms, evidence of occurrence:
Severe hemolysis due to passenger lymphocyte syndrome (PLS) in all three recipients of organs from a single donor with multiple red blood cell (RBC) alloantibodies.
Demonstration of imputability or root cause:
Donor: male, blood group O, Rh (D) negative (rr) with a positive antibody screen due to anti-D, -C and -k. Liver recipient: blood group B, Rh (D) positive [R1R1], K–k+. From PTD 0 to 13, Hb fell from 102 to 64 g/L with marked spherocytosis, a positive DAT (IgG), elevated markers of hemolysis and no bleeding. The antibody screen was positive due to anti-D. A RC elution demonstrated the presence of anti-B, -C and -k in addition to anti-D.
Imputability grade:
3 Definite/Certain/Proven
Groups audience:
Keywords:
Suggest new keywords:
anti-D
anti-B
anti-C
anti-k
Reference attachment:
Suggest references:
Shortt, J., Westall, G.P., Roxby,, D.,Chen, J. W., Snell, G.I., Polizzotto, M.N., Magrin, G., Webb, A., Street, A.M., Borosak, M., Wood, E.M. and Cole-Sinclair, M.F. (2008). A 'dangerous' group O donor: severe hemolysis in all recipients of organs from a donor with multiple red cell alloantibodies. Am J Transplant 8(3): 711-14.
Note:
The Notify team will create the "twin" record for the other MPHO involved (two single lung transplant recipients) once the blank fields are completed and the status is changed in "ready to upload" by the editors (Evi) --> see record 1652
Expert comments for publication:
Well documented passenger lymphyocyte mediated hemolysis. Donor characterized antimortem by red cross reference lab.