Abstract

PAREDES-FERNANDEZ, Antonio; GOMEZ-RAMIREZ, Diego  and  KURATOMI-NAKAMURA, Kenyi. Passenger lymphocyte syndrome due to anti-D antibodies in liver transplantation. Case report. Rev. colomb. Gastroenterol. [online]. 2022, vol.37, n.4, pp.444-448.  Epub July 10, 2023. ISSN 0120-9957.  https://doi.org/10.22516/25007440.814.

Passenger lymphocyte syndrome (PLS) is a graft-versus-host complication in solid organ transplantation or hematopoietic stem cell transplantation. It is a major cause of immune hemolysis after transplantation caused by the production of antibodies by the specific clones of viable B lymphocytes transferred through the donor organ against the antigens of the recipient’s red blood cells. It usually occurs in transplants with minor ABO or Rh mismatch. This descriptive study explains the case of a 54-year-old patient with O/Rh(D) positive blood group, with cirrhosis secondary to metabolic disease associated with fatty liver (NAFLD), who underwent liver transplantation from an O/Rh(D) negative donor. Nine days after the transplant, the patient presented with immune hemolytic anemia due to anti-D antibodies because of the transient B lymphocyte from the sensitized donor. The patient received support measures, transfusion of red blood cells, and immunosuppression with steroids, which stabilized the hemolytic parameters. In conclusion, this entity should be suspected in the case of acute hemolytic anemia in the post-transplant period.

Keywords : Direct Coombs test; hemolytic anemia; liver transplantation; case report..

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