Autoimmune cytopaenia after paediatric intestinal transplantation: a case series

Arcos, Gonzalo Botija; Ybarra, Marta; Ramos, Esther; Molina, Manuel; Sarriá, J.; Martínez-Ojinaga, Eva; Andrés, Ane Miren; López‐Santamaría, Manuel; Prieto, Gerardo

doi:10.1111/j.1432-2277.2010.01091.x

Cited by 25 publications

(45 citation statements)

References 24 publications

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“…Immune-mediated hemolytic anemia may be alloimmune or autoimmune. In contrast to alloimmune hemolytic anemia, autoimmune mediated hemolysis occurs after months to years and is an uncommon cause of hemolytic anemia after transplant surgery [22]. In addition, some drugs may function as haptens generating immune complexes that lead to positive DATs with nonreactive eluates and undetectable autoantibodies [18].…”

Section: Discussionmentioning

confidence: 99%

Passenger lymphocyte syndrome in ABO and Rhesus D minor mismatched liver and kidney transplantation: A prospective analysis

El-Ansary¹,

Hanna²,

Saadi³

et al. 2015

Human Immunology

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Section: Discussionmentioning

confidence: 99%

Passenger lymphocyte syndrome in ABO and Rhesus D minor mismatched liver and kidney transplantation: A prospective analysis

El-Ansary¹,

Hanna²,

Saadi³

et al. 2015

Human Immunology

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“…Botija and colleagues [42] observed autoimmune cytopenia in 6 of 49 (12.2%) patients at the median time of 10 months after intestinal transplantation. Warm autoimmune-type hemolytic anemia developed in three patients, cold autoimmune-type hemolytic anemia developed in one patient, and two patients presented with a mixed type of hemolytic anemia.…”

Section: Hematologic Toxicitymentioning

confidence: 97%

Intestinal Transplantation in Children

Nayyar

McGhee

Martin³

et al. 2011

Pediatric Drugs

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This review summarizes the outcomes and known adverse effects of current immunosuppression strategies in use in pediatric intestinal transplantation. Intestinal transplantation has evolved from an experimental therapy to a highly successful treatment for children with intestinal failure who have complications with total parenteral nutrition. Because of continued success with intestinal transplantation over the past decade, the focus of clinicians and researchers is shifting from short-term patient survival to optimizing long-term outcomes. Current 5-year patient and graft survival rates after intestinal transplantation are 58% and 40%, respectively, in the US; single centers have reported nearly 80% patient and 60% graft survival rates at 5 years. The immunosuppression strategy in intestinal transplantation includes a tacrolimus-based regimen, usually in conjunction with an antibody induction therapy such as rabbit-antithymocyte globulin, interleukin-2 receptor antagonists, or alemtuzumab. The use of these immunosuppressive regimens, along with improved medical and surgical care, has contributed significantly toward improved outcomes. Optimization of post-transplant immunosuppression strategies to reduce adverse effects while minimizing acute and chronic graft rejection is a strong clinical and research focus.

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“…Bacterial bloodstream due to intestinal bacterial translocation and viral infection (basically cytomegalovirus) are the most frequent agents. Hematological disorders and autoimmune cytopenia is a rare but severe complication after solid organ transplantation [37]. The immunosuppressive therapies used, associated with other concomitant factors such as viral infections, lymphoproliferative disorders, GVHD or passenger lymphocyte syndrome, play an important role in the development of autoimmune processes after intestinal transplantation.…”

Section: Other Complicationsmentioning

confidence: 99%

Pediatric small bowel transplantation

Boluda

2015

Current Opinion in Organ Transplantation

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Parenteral nutrition remains the main therapeutic resource in the management of intestinal failure, but intestinal transplant is a therapeutic option when this therapy has failed. Finding the balanced immunosuppression that minimizes risk of rejection while preventing occurrence of complications like post-transplant lymphoproliferative disease or GVHD is an ongoing challenge. The current survival rates of intestinal transplantation are similar to other solid organ transplant.

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Autoimmune cytopaenia after paediatric intestinal transplantation: a case series

Cited by 25 publications

References 24 publications

Passenger lymphocyte syndrome in ABO and Rhesus D minor mismatched liver and kidney transplantation: A prospective analysis

Passenger lymphocyte syndrome in ABO and Rhesus D minor mismatched liver and kidney transplantation: A prospective analysis

Intestinal Transplantation in Children

Pediatric small bowel transplantation

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