Heart Rejection anti-B

Status:

Ready to upload

Record number:

1586

Adverse Occurrence type:

Rejection

MPHO Type:

Heart

Estimated frequency:

Case report

Time to detection:

5 days

Alerting signals, symptoms, evidence of occurrence:

Anti-B IgM antibody titer rise beginning on day 5, anti-B IgG rise beginning day 7 post heart transplant.

Demonstration of imputability or root cause:

Frank clinical cardiac rejection in a blood group A recipient who received a group B cardiac allograft. Histologic confirmation included diffuse destruction of the microvasculature and endothelial necrosis in larger vessels, associated with neutrophilic inflammation of vessels beginning on day 5.

Imputability grade:

3 Definite/Certain/Proven

Groups audience:

Clinical complications

Keywords:

TPE (therapeutic plasma exchange)

histology

serology

anti-B

References:

Anti-B-mediated rejection of an ABO-incompatible cardiac allograft despite aggressive plasma exchange transfusion.

Reference attachment:

Rejection anti-B, Pikul, 1987.pdf

Suggest references:

Pikul, F. J., Bolman, R. M., Saffitz, J. E. and Chaplin, H. (1987). Anti-B-mediated rejection of an ABO-incompatible cardiac allograft despite aggressive plasma exchange transfusion. Transplant Proc 19(6): 4601-4604.

Expert comments for publication:

1) 1987 case report of heart from a group B donor transplanted into a group A recipient with baseline anti-B titer of 1:32. 2) Daily plasma exchanges beginning on day 5 with group AB plasma (only 3 liters in volume) failed to prevent rise in anti-B titer.