Passenger Lymphocyte Syndrome With or Without Immune Hemolytic Anemia in all Rh-Positive Recipients of Lungs From Rhesus Alloimmunized Donors: Three New Cases and a Review of the Literature

Cserti‐Gazdewich, Christine; Waddell, Thomas K.; Singer, Lianne G.; Chaparro, Cecilia; Pendergrast, Jacob; Hawes, Judith; denHollander, Neal; Tinckam, Kathryn; Keshavjee, Shaf

doi:10.1016/j.tmrv.2008.12.003

Cited by 33 publications

(23 citation statements)

References 47 publications

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“…Antibody against D antigen has also been reported. [32][33][34] Onset is between 3 and 24 days. In one study of 43 patients, 36 had IgG antibody, 35 had C3, and 28 had both.…”

Section: Association Of Immune Hemolysis With Orthotopic Solid Organ mentioning

confidence: 99%

Immune hemolytic anemia—selected topics

Hoffman¹

2009

Hematology

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Autoimmune hemolytic anemia (AIHA) is most often idiopathic. However, in recent years, AIHA has been noted with increased incidence in patients receiving purine nucleoside analogues for hematologic malignancies; it has also been described as a complication of blood transfusion in patients who have also had alloimmunization. As the technology of hematopoietic stem cell transplantation has become more widespread, immune hemolysis in the recipients of ABO-mismatched products has become better recognized. The syndrome is caused by passenger lymphocytes transferred from the donor and, although transient, can be quite severe. A similar syndrome has been observed in recipients of solid organ transplants when there is ABO-incompatibility between donor and recipient. Venous thromboembolism is a little-recognized, though likely common, complication of AIHA, and may in some instances be related to coexistent antiphospholipid antibodies. While AIHA is a well-documented complication of malignant lymphoproliferative disorders, lymphoproliferative disorders may also paradoxically appear as a consequence of AIHA. A number of newer options are available for treatment of AIHA in patients refractory to corticosteroids and splenectomy. Newer immunosuppressives such as mycophenolate mofetil may have a role in such cases. Considerable experience has been accumulating in the last few years with monoclonal antibody therapy, mainly rituximab, in difficult AIHA cases; it appears to be a safe and effective option.

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“…Antibody against D antigen has also been reported. [32][33][34] Onset is between 3 and 24 days. In one study of 43 patients, 36 had IgG antibody, 35 had C3, and 28 had both.…”

Section: Association Of Immune Hemolysis With Orthotopic Solid Organ mentioning

confidence: 99%

Immune hemolytic anemia—selected topics

Hoffman¹

2009

Hematology

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“…Cserti-Gazdewich et al [9], reported that PLS severity was variable even in recipients of paired allografts from the same sensitized donor. It was also observed that antibodies may be detected, although hemolysis may not occur [2].…”

Section: Discussionmentioning

confidence: 99%

“…Presently, it is not completely understood which recipients of minor mismatched organs will develop passenger lymphocyte derived antibodies and hemolysis. It was proposed that donor B-lymphocytes only induce an immune response when they occur with stimulation such as the transfusion of stored blood [9] or through infection [13].…”

Section: Discussionmentioning

confidence: 99%

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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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“…Most cases are due to ABO incompatibility; however, rare cases are attributed to other blood groups such as Rh, Kidd, Kell, and Duffy [24][25][26]. Hemolysis typically begins 7-14 days post transplant and lasts 5-10 days with rare cases having persistent evidence of antibody production and hemolysis [26].…”

Section: Passenger Lymphocyte Syndromementioning

confidence: 99%

The direct antiglobulin test: A critical step in the evaluation of hemolysis

et al. 2012

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The direct antiglobulin test (DAT) is a laboratory test that detects immunoglobulin and/or complement on the surface of red blood cells. The utility of the DAT is to sort hemolysis into an immune or nonimmune etiology. As with all tests, DAT results must be viewed in light of clinical and other laboratory data. This review highlights the most common clinical situations where the DAT can help classify causes of hemolysis, including autoimmune hemolytic anemia, transfusion-related hemolysis, hemolytic disease of the fetus/newborn, drug-induced hemolytic anemia, passenger lymphocyte syndrome, and DAT-negative hemolytic anemia. In addition, the pitfalls and limitations of the test are addressed. False reactions may occur with improper technique, including improper washing, centrifugation, and specimen agitation at the time of result interpretation. Patient factors, such as spontaneous red blood cell agglutination, may also contribute to false results. Am. J. Hematol. 87:707-709, 2012. V

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Passenger Lymphocyte Syndrome With or Without Immune Hemolytic Anemia in all Rh-Positive Recipients of Lungs From Rhesus Alloimmunized Donors: Three New Cases and a Review of the Literature

Cited by 33 publications

References 47 publications

Immune hemolytic anemia—selected topics

Immune hemolytic anemia—selected topics

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

The direct antiglobulin test: A critical step in the evaluation of hemolysis

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