Severe hemolytic anemia due to passenger lymphocytes after living‐related bowel transplant
: Background: Hemolytic anemia following solid organ transplant may be caused by ‘passenger’ lymphocytes producing antibodies against erythrocytes. This phenomenon has never been described after intestinal transplant. Materials and methods: We report a case of severe, immune‐mediated hemolysis du...
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| Veröffentlicht in: | Clinical transplantation 2004-06, Vol.18 (3), p.332-335 |
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| creator | Panaro, F DeChristopher, PJ Rondelli, D Testa, G Sankary, H Popescu, M Benedetti, E |
| description | : Background: Hemolytic anemia following solid organ transplant may be caused by ‘passenger’ lymphocytes producing antibodies against erythrocytes. This phenomenon has never been described after intestinal transplant.
Materials and methods: We report a case of severe, immune‐mediated hemolysis due to symptomatic passenger lymphocyte syndrome (PLS) in a 4‐yr‐old recipient of living donor small bowel transplant. The Coombs’‐positive hemolysis was caused by anti‐A,B antibodies derived from donor lymphocytes in an ABO‐compatible donor–recipient pair (O into A).
Results: This complication was successfully and efficiently treated by the novel combined use of group O RBC transfusion, plasmapheresis and rituximab (anti‐CD20).
Conclusions: A severe hemolytic anemia due to PLS can occur in bowel transplantation. This complication should be considered when performing ABO‐incompatible bowel transplant with a blood group O donor and an A or B recipient. Treatment with plasmapheresis, blood group O transfusion and rituximab has proved successful in our case. |
| doi_str_mv | 10.1111/j.1399-0012.2004.00158.x |
| format | Article |
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Materials and methods: We report a case of severe, immune‐mediated hemolysis due to symptomatic passenger lymphocyte syndrome (PLS) in a 4‐yr‐old recipient of living donor small bowel transplant. The Coombs’‐positive hemolysis was caused by anti‐A,B antibodies derived from donor lymphocytes in an ABO‐compatible donor–recipient pair (O into A).
Results: This complication was successfully and efficiently treated by the novel combined use of group O RBC transfusion, plasmapheresis and rituximab (anti‐CD20).
Conclusions: A severe hemolytic anemia due to PLS can occur in bowel transplantation. This complication should be considered when performing ABO‐incompatible bowel transplant with a blood group O donor and an A or B recipient. Treatment with plasmapheresis, blood group O transfusion and rituximab has proved successful in our case.</description><identifier>ISSN: 0902-0063</identifier><identifier>EISSN: 1399-0012</identifier><identifier>DOI: 10.1111/j.1399-0012.2004.00158.x</identifier><identifier>PMID: 15142057</identifier><language>eng</language><publisher>Oxford, UK: Munksgaard International Publishers</publisher><subject>ABO Blood-Group System - immunology ; Anemia, Hemolytic - etiology ; Anemia, Hemolytic - immunology ; Anemia, Hemolytic - therapy ; Anemias. Hemoglobinopathies ; Antibodies, Monoclonal - therapeutic use ; Antibodies, Monoclonal, Murine-Derived ; Biological and medical sciences ; Cardiology. Vascular system ; Child, Preschool ; Diseases of red blood cells ; Erythrocyte Transfusion ; Erythrocytes - immunology ; General aspects ; Hematologic and hematopoietic diseases ; hemolytic anemia ; Humans ; Immunosuppressive Agents - therapeutic use ; Intestines - transplantation ; living donor ; Living Donors ; Lymphocytes - immunology ; Male ; Medical sciences ; Organ Transplantation - adverse effects ; Organ Transplantation - methods ; passenger lymphocyte syndrome ; Plasmapheresis - methods ; Rituximab ; small bowel transplant ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Treatment Outcome</subject><ispartof>Clinical transplantation, 2004-06, Vol.18 (3), p.332-335</ispartof><rights>2004 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4608-b753a3164fd2eb7c806ba5b442094c3d1600b931af548a8d5f2c7d997e343313</citedby><cites>FETCH-LOGICAL-c4608-b753a3164fd2eb7c806ba5b442094c3d1600b931af548a8d5f2c7d997e343313</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1399-0012.2004.00158.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1399-0012.2004.00158.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=15778372$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15142057$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Panaro, F</creatorcontrib><creatorcontrib>DeChristopher, PJ</creatorcontrib><creatorcontrib>Rondelli, D</creatorcontrib><creatorcontrib>Testa, G</creatorcontrib><creatorcontrib>Sankary, H</creatorcontrib><creatorcontrib>Popescu, M</creatorcontrib><creatorcontrib>Benedetti, E</creatorcontrib><title>Severe hemolytic anemia due to passenger lymphocytes after living‐related bowel transplant</title><title>Clinical transplantation</title><addtitle>Clin Transplant</addtitle><description>: Background: Hemolytic anemia following solid organ transplant may be caused by ‘passenger’ lymphocytes producing antibodies against erythrocytes. This phenomenon has never been described after intestinal transplant.
Materials and methods: We report a case of severe, immune‐mediated hemolysis due to symptomatic passenger lymphocyte syndrome (PLS) in a 4‐yr‐old recipient of living donor small bowel transplant. The Coombs’‐positive hemolysis was caused by anti‐A,B antibodies derived from donor lymphocytes in an ABO‐compatible donor–recipient pair (O into A).
Results: This complication was successfully and efficiently treated by the novel combined use of group O RBC transfusion, plasmapheresis and rituximab (anti‐CD20).
Conclusions: A severe hemolytic anemia due to PLS can occur in bowel transplantation. This complication should be considered when performing ABO‐incompatible bowel transplant with a blood group O donor and an A or B recipient. Treatment with plasmapheresis, blood group O transfusion and rituximab has proved successful in our case.</description><subject>ABO Blood-Group System - immunology</subject><subject>Anemia, Hemolytic - etiology</subject><subject>Anemia, Hemolytic - immunology</subject><subject>Anemia, Hemolytic - therapy</subject><subject>Anemias. Hemoglobinopathies</subject><subject>Antibodies, Monoclonal - therapeutic use</subject><subject>Antibodies, Monoclonal, Murine-Derived</subject><subject>Biological and medical sciences</subject><subject>Cardiology. Vascular system</subject><subject>Child, Preschool</subject><subject>Diseases of red blood cells</subject><subject>Erythrocyte Transfusion</subject><subject>Erythrocytes - immunology</subject><subject>General aspects</subject><subject>Hematologic and hematopoietic diseases</subject><subject>hemolytic anemia</subject><subject>Humans</subject><subject>Immunosuppressive Agents - therapeutic use</subject><subject>Intestines - transplantation</subject><subject>living donor</subject><subject>Living Donors</subject><subject>Lymphocytes - immunology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Organ Transplantation - adverse effects</subject><subject>Organ Transplantation - methods</subject><subject>passenger lymphocyte syndrome</subject><subject>Plasmapheresis - methods</subject><subject>Rituximab</subject><subject>small bowel transplant</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Treatment Outcome</subject><issn>0902-0063</issn><issn>1399-0012</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkMtKxDAUhoMoOl5eQbLR3dSkSZoW3MjgDQRBZymEND3VDunFpKN25yP4jD6JqTOoS7PJ4eQ7Jz8fQpiSiIZzsogoy7IpITSOYkJ4FCqRRm8baPLzsIkmJCNxqBO2g3a9X4RuQhOxjXaooDwmQk7Qwz28gAP8BHVrh74yWDdQVxoXS8B9izvtPTSP4LAd6u6pNUMPHuuyHzvVS9U8fr5_OLC6hwLn7StY3Dvd-M7qpt9HW6W2Hg7W9x6aX5zPZ1fTm9vL69nZzdTwhKTTXAqmGU14WcSQS5OSJNci5yFixg0raEJInjGqS8FTnRaijI0sskwC44xRtoeOV2s71z4vwfeqrrwBGyJAu_RK0izmqUgCmK5A41rvHZSqc1Wt3aAoUaNYtVCjPzX6U6NY9S1WvYXRw_Ufy7yG4ndwbTIAR2tAe6NtGSSYyv_hpEyZjAN3uuJeKwvDvwOo2fwuFOwLVJuVLQ</recordid><startdate>200406</startdate><enddate>200406</enddate><creator>Panaro, F</creator><creator>DeChristopher, PJ</creator><creator>Rondelli, D</creator><creator>Testa, G</creator><creator>Sankary, H</creator><creator>Popescu, M</creator><creator>Benedetti, E</creator><general>Munksgaard International Publishers</general><general>Blackwell</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200406</creationdate><title>Severe hemolytic anemia due to passenger lymphocytes after living‐related bowel transplant</title><author>Panaro, F ; DeChristopher, PJ ; Rondelli, D ; Testa, G ; Sankary, H ; Popescu, M ; Benedetti, E</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4608-b753a3164fd2eb7c806ba5b442094c3d1600b931af548a8d5f2c7d997e343313</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>ABO Blood-Group System - immunology</topic><topic>Anemia, Hemolytic - etiology</topic><topic>Anemia, Hemolytic - immunology</topic><topic>Anemia, Hemolytic - therapy</topic><topic>Anemias. Hemoglobinopathies</topic><topic>Antibodies, Monoclonal - therapeutic use</topic><topic>Antibodies, Monoclonal, Murine-Derived</topic><topic>Biological and medical sciences</topic><topic>Cardiology. Vascular system</topic><topic>Child, Preschool</topic><topic>Diseases of red blood cells</topic><topic>Erythrocyte Transfusion</topic><topic>Erythrocytes - immunology</topic><topic>General aspects</topic><topic>Hematologic and hematopoietic diseases</topic><topic>hemolytic anemia</topic><topic>Humans</topic><topic>Immunosuppressive Agents - therapeutic use</topic><topic>Intestines - transplantation</topic><topic>living donor</topic><topic>Living Donors</topic><topic>Lymphocytes - immunology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Organ Transplantation - adverse effects</topic><topic>Organ Transplantation - methods</topic><topic>passenger lymphocyte syndrome</topic><topic>Plasmapheresis - methods</topic><topic>Rituximab</topic><topic>small bowel transplant</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Panaro, F</creatorcontrib><creatorcontrib>DeChristopher, PJ</creatorcontrib><creatorcontrib>Rondelli, D</creatorcontrib><creatorcontrib>Testa, G</creatorcontrib><creatorcontrib>Sankary, H</creatorcontrib><creatorcontrib>Popescu, M</creatorcontrib><creatorcontrib>Benedetti, E</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Panaro, F</au><au>DeChristopher, PJ</au><au>Rondelli, D</au><au>Testa, G</au><au>Sankary, H</au><au>Popescu, M</au><au>Benedetti, E</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Severe hemolytic anemia due to passenger lymphocytes after living‐related bowel transplant</atitle><jtitle>Clinical transplantation</jtitle><addtitle>Clin Transplant</addtitle><date>2004-06</date><risdate>2004</risdate><volume>18</volume><issue>3</issue><spage>332</spage><epage>335</epage><pages>332-335</pages><issn>0902-0063</issn><eissn>1399-0012</eissn><abstract>: Background: Hemolytic anemia following solid organ transplant may be caused by ‘passenger’ lymphocytes producing antibodies against erythrocytes. This phenomenon has never been described after intestinal transplant.
Materials and methods: We report a case of severe, immune‐mediated hemolysis due to symptomatic passenger lymphocyte syndrome (PLS) in a 4‐yr‐old recipient of living donor small bowel transplant. The Coombs’‐positive hemolysis was caused by anti‐A,B antibodies derived from donor lymphocytes in an ABO‐compatible donor–recipient pair (O into A).
Results: This complication was successfully and efficiently treated by the novel combined use of group O RBC transfusion, plasmapheresis and rituximab (anti‐CD20).
Conclusions: A severe hemolytic anemia due to PLS can occur in bowel transplantation. This complication should be considered when performing ABO‐incompatible bowel transplant with a blood group O donor and an A or B recipient. Treatment with plasmapheresis, blood group O transfusion and rituximab has proved successful in our case.</abstract><cop>Oxford, UK</cop><pub>Munksgaard International Publishers</pub><pmid>15142057</pmid><doi>10.1111/j.1399-0012.2004.00158.x</doi><tpages>4</tpages></addata></record> |
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| subjects | ABO Blood-Group System - immunology Anemia, Hemolytic - etiology Anemia, Hemolytic - immunology Anemia, Hemolytic - therapy Anemias. Hemoglobinopathies Antibodies, Monoclonal - therapeutic use Antibodies, Monoclonal, Murine-Derived Biological and medical sciences Cardiology. Vascular system Child, Preschool Diseases of red blood cells Erythrocyte Transfusion Erythrocytes - immunology General aspects Hematologic and hematopoietic diseases hemolytic anemia Humans Immunosuppressive Agents - therapeutic use Intestines - transplantation living donor Living Donors Lymphocytes - immunology Male Medical sciences Organ Transplantation - adverse effects Organ Transplantation - methods passenger lymphocyte syndrome Plasmapheresis - methods Rituximab small bowel transplant Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Treatment Outcome |
| title | Severe hemolytic anemia due to passenger lymphocytes after living‐related bowel transplant |
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