Transmission of idiopathic thrombocytopenic purpura during orthotopic liver transplantation

Pereboom, Ilona T. A.; Boer, Marieke T. de; Haagsma, Elizabeth B.; Heide, Frans van der; Porcelijn, Leendert; Lisman, Ton; Porte, Robert J.

doi:10.1111/j.1432-2277.2009.00936.x

Cited by 19 publications

(21 citation statements)

References 6 publications

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“…Two patients had ITP relapse, which were controlled medically in one case and with splenectomy in the other (22, 23). ITP can be transmitted from donor to recipient (26).…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of adult ITP after LT was 0.7%, almost half the incidence observed in our patient population, none had any evidence of acute viral infection (23). Alloimmunity (donor‐derived plasma cells in ABO incompatible donors) is a potential cause in some case of autoimmune cytopenias (26). All patients in our case series received ABO compatible transplants; therefore, alloimmunity was ruled out as a potential cause.…”

Section: Discussionmentioning

confidence: 99%

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Autoimmune hemolytic anemia and idiopathic thrombocytopenic purpura in pediatric solid organ transplant recipients, report of five cases and review of the literature

Miloh

Arnon

Roman

et al. 2011

Pediatric Transplantation

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Cytopenias are common among pediatric SOT; however, autoimmune cytopenias are infrequently reported. We report five cases of autoimmune cytopenias in pediatric LT patients: two with isolated IgG-mediated AIHA, two with ITP, and one with Evans syndrome (ITP and AIHA). All patients were maintained on tacrolimus as immunosuppression. Viral illness commonly preceded the autoimmune cytopenias. All patients responded well to medical therapy (steroids, intravenous immunoglobulin, and rituximab) and lowering tacrolimus serum level. Prognosis appears to be worse when more than one cell line (e.g., Evans syndrome) is affected, and/or there is no preceding viral illness. A critical literature review of autoimmune cytopenias in children following SOT is conducted. Autoimmune cytopenias are a rarely reported complication of pediatric SOT, but clinicians taking care of pediatric transplant recipients need to be aware of this complication.

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“…Two patients had ITP relapse, which were controlled medically in one case and with splenectomy in the other (22, 23). ITP can be transmitted from donor to recipient (26).…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Autoimmune hemolytic anemia and idiopathic thrombocytopenic purpura in pediatric solid organ transplant recipients, report of five cases and review of the literature

Miloh

Arnon

Roman

et al. 2011

Pediatric Transplantation

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“…ITP is a chronic autoimmune disorder characterized by the destruction of autologous platelets by autoantibodies directed against platelet‐surface constituents. ITP commonly manifests as asymptomatic thrombocytopenia, muco‐cutaneous bleeding, and/or bruising . The incidence of post‐LT ITP is approximately 0.7% .…”

Section: Idiopathic Thrombocytopenic Purpuramentioning

confidence: 99%

“…These affected patients are typically treated with steroids, intravenous immunoglobulin infusions, and/or rituximab with resolution. Rarely, refractory patients undergo splenectomy …”

Section: Idiopathic Thrombocytopenic Purpuramentioning

confidence: 99%

Genetic, hematological, and immunological disorders transmissible with liver transplantation

Tan¹,

Florman

Schiano

2017

Liver Transpl

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It is well recognized that solid organ transplantation can transmit bacterial infection and chronic viral hepatitis as well as certain cancers. As indications for liver transplantation (LT) have expanded, it has been used to treat and even cure certain genetic cholestatic disorders, urea cycle defects, and coagulation abnormalities; many of these conditions are potentially transmissible with LT as well. It is important for clinicians and transplant patients to be aware of these potentially transmissible conditions as unexplained post-LT complications can sometimes be related to donor transmission of disease and thus should prompt a thorough exploration of the donor allograft history. Herein, we will review the reported genetic, metabolic, hematologic, and immunological disorders that are transmissible with LT and describe clinical scenarios in which these cases have occurred, such as in inadvertent or recognized transplantation of a diseased organ, domino transplantation, and with living related liver donation. Liver Transplantation 23 663-678 2017 AASLD.

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“…Other examples of recipient acquired cellular and/or antibody immunity caused by concomitant transfer of donor lymphocytes following solid organ The HLA-antibody specificities show antigen-specific absorption/modulation against self-HLA (recipient own HLA type) and closely related cross-reactive epitopes (self-CREG), and examples of high-level third party antibodies that are not related to the recipient HLA type. transplantation include idiopathic thrombocytopenia (13), vitiligo (14), and peanut allergy (15). In patients with graftversus-host disease after liver, lung, or intestinal transplantation donor T cell chimerism is well described (12), but is very rare after kidney or heart transplantation.…”

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confidence: 99%

Transfer of HLA-Specific Allosensitization From a Highly Sensitized Deceased Organ Donor to the Recipients of Each Kidney

Maxfield

Taylor

Kosmoliaptsis

et al. 2015

American Journal of Transplantation

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We report for the first time the adoptive transfer of donor HLA‐specific allosensitization in two recipients following kidney transplantation from a highly sensitized donor. Kidneys from a donation after circulatory death donor were transplanted into two nontransfused, HLA‐specific antibody negative males receiving their first transplant. Antibody screening 7 days after transplant showed high level de novo IgG HLA class I‐ and class II‐specific antibodies in both recipients, with largely overlapping antibody profiles but no antibodies to donor HLA. The unusually rapid appearance of de novo alloantibodies in immunosuppressed nonsensitized recipients and absence of donor HLA‐specific antibody prompted testing of stored donor serum that revealed high antibody levels with specificities very similar to those seen in both recipients, but in addition the presence of strong antibodies to each recipient HLA. Alloantibody levels gradually declined but were still detectable at 3 months. These findings suggest that alloreactive passenger B cells/plasma cells within the kidneys of highly sensitized donors may give rise to rapid development of posttransplant de novo HLA‐specific alloantibodies. While the clinical significance of this phenomenon is uncertain it provides one explanation for the appearance of de novo HLA‐specific antibodies directed against third party but not donor HLA.

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Transmission of idiopathic thrombocytopenic purpura during orthotopic liver transplantation

Cited by 19 publications

References 6 publications

Autoimmune hemolytic anemia and idiopathic thrombocytopenic purpura in pediatric solid organ transplant recipients, report of five cases and review of the literature

Autoimmune hemolytic anemia and idiopathic thrombocytopenic purpura in pediatric solid organ transplant recipients, report of five cases and review of the literature

Genetic, hematological, and immunological disorders transmissible with liver transplantation

Transfer of HLA-Specific Allosensitization From a Highly Sensitized Deceased Organ Donor to the Recipients of Each Kidney

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