Status:
Ready to upload
Record number:
1169
Adverse Occurrence type:
MPHO Type:
Time to detection:
10 days
Alerting signals, symptoms, evidence of occurrence:
On day 10 of the second liver transplant, clinical hemolysis ensued; anti-Jka was detected. The patient's DAT became positive, and anti-Jka was eluted from his red blood cells, whereas the second donor’s RBCs were Jk(a−).
Demonstration of imputability or root cause:
Passenger lymphocyte syndrome occurs when immunocompetent donor lymphocytes transferred during transplantation produce alloantibodies against host antigens. The patient, typed group O, D+, and Jk(a+), received a second liver transplant from a Jk(a-) donor. Despite mmunosuppressive treatment, the patient developed a hemolytic reaction, as evidenced by a drop in the Hb and an increase of LDH levels at 11 days after transplantation. The transfusion reaction was self-limited and subsided when all further units given to the patient were Jk(a-). The patient's DAT became positive and anti-JK(a) was eluted from his RBCs.
Imputability grade:
3 Definite/Certain/Proven
Groups audience:
Keywords:
Suggest new keywords:
anti-Jk(a), acute transfusion reaction
Reference attachment:
Suggest references:
Hareuveni, M, Merchav, H., Austerlitz, N., Rahimi-Levene, N.and Ben-Tal, O. (2002). Donor anti-Jk(a) causing hemolysis in a liver transplant recipient. Transfusion 42:363-7.
Expert comments for publication:
Kidd antibodies, anti-Jka, -Jkb, and -Jk3, have been responsible for severe and fatal immediate and delayed reactions.