Passenger lymphocyte syndrome in liver transplant recipients: a description of 12 cases

Fecha de publicación: 01/07/2015

Autores de IIS La Fe

Samuel Romero Domínguez

Autor
Pilar Solves Alcaina

Autor
Alma Lancharro

Autor
Isabel Cano Ferri

Autor
Federico Moscardo Garcia

Autor
Nelly Carpio Martinez

Autor
Miguel Ángel Sanz Alonso

Autor

Grupos

Hematología y Hemoterapia

Investigador Principal

Javier De La Rubia Comos

Abstract

Background. Passenger lymphocyte syndrome is an important cause of immune haemolysis after solid organ transplantation. It mainly occurs in minor ABO and Rh mismatched transplants. The haemolysis is usually mild and self-limited. We present our experience in passenger lymphocyte syndrome and liver transplantation and review the literature. Materials and methods. We reviewed liver transplants performed in our centre from January 2002 to September 2013, searching for ABO or Rh incompatibility and serological findings of haemolysis. A direct antiglobulin test was systematically performed in each pre-transfusion assessment. Results. A total of 1,217 liver transplants were performed and 12 passenger lymphocyte syndromes were detected: of the 56 cases with minor ABO incompatibility, ten patients developed passenger lymphocyte syndrome (17.9%) and of 147 cases with minor Rh incompatibility, two patients developed the syndrome (1.40%). All patients with passenger lymphocyte syndrome had haemolysis, a decrease of haemoglobin (median 6.8 g/dL) and an increase of bilirubin (median 5.15 mg/dL). The treatment of passenger lymphocyte syndrome consisted of increasing the dose of corticosteroids that the patients were receiving as post-transplantation immunosuppressive therapy and, in the majority of cases, transfusion of donor compatible red blood cells. Discussion. Passenger lymphocyte syndrome in liver transplantation has significant clinical consequences. It is, therefore, important to make the diagnosis rapidly, performing pre-transfusion direct antiglobulin tests, and manage the problem correctly with donor compatible red blood cell transfusions and/or immunosuppressive treatment.

Datos de la publicación

ISSN/ISSNe:: 1723-2007, 2385-2070
Tipo:: Article
Páginas:: 423-428
DOI:: 10.2450/2015.0148-14
Factor de Impacto:: 0,650 SCImago ℠
Cuartil:: Q2 SCImago ℠

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Métricas

Filiaciones

Romero S:: Department of Haematology and Haemotherapy, La Fe University Hospital, Valencia, Spain
Solves P:: Department of Haematology and Haemotherapy, La Fe University Hospital, Valencia, Spain
Lancharro A:: Department of Haematology and Haemotherapy, La Fe University Hospital, Valencia, Spain
Cano I:: Department of Haematology and Haemotherapy, La Fe University Hospital, Valencia, Spain
Moscardó F:: Department of Haematology and Haemotherapy, La Fe University Hospital, Valencia, Spain
Carpio N:: Department of Haematology and Haemotherapy, La Fe University Hospital, Valencia, Spain
Sanz MÁ:: Department of Haematology and Haemotherapy, La Fe University Hospital, Valencia, Spain

Keywords

direct antiglobulin test; haemolysis; liver transplantation; passenger lymphocyte syndrome; red blood cells

Campos de estudio

Proyectos asociados

RED DE INVESTIGACION COOPERATIVA DE CANCER

RD06/0020/0031 . INSTITUTO DE SALUD CARLOS III; FUNDACIÓN PARA LA INVESTIGACIÓN DEL HOSPITAL UNIVERSITARIO LA FE DE LA COMUNIDAD VALENCIANA . 2006

PROYECTO CAIBER

CAI08/01/0061 . INSTITUTO DE SALUD CARLOS III; FUNDACIÓN PARA LA INVESTIGACIÓN DEL HOSPITAL UNIVERSITARIO LA FE DE LA COMUNIDAD VALENCIANA . 2009

CREACION Y MEJORA DE INFRAESTRUCTURAS EN MEDICINA REGENERATIVA

Investigador Principal: FUNDACIÓN PARA LA INVESTIGACIÓN DEL HOSPITAL UNIVERSITARIO LA FE DE LA COMUNIDAD VALENCIANA

PLE2009-0141 ACI-PLAN E . MINISTERIO DE CIENCIA E INNOVACION; FUNDACIÓN PARA LA INVESTIGACIÓN DEL HOSPITAL UNIVERSITARIO LA FE DE LA COMUNIDAD VALENCIANA . 2009