Acute transplant rejection induced by blood transfusion reaction to the Kidd blood group system

Abstract

Many renal transplant centres now try to avoid blood transfusion prior to renal transplantation, to avoid alloimmunization due to antibody production against donor antigens usually present on contaminating white cells. Post- or peri-operative transfusions are usually not considered to present problems, since the patient is heavily immunosuppressed. We present a patient who suffered a rare transfusion reaction, that we believe may have initiated a severe vascular rejection of a kidney transplant, probably mediated by Kidd blood group antigens.

Understanding red blood cell alloimmunization triggers

“…For example, recipient alloantibodies against Jk antigens have been described to impact the outcomes of transplanted kidneys from Jk-positive donors. 5,6 RBC phenotyping, or the evaluation of antigen expression on RBCs using serologic methodology, has historically been used to characterize a particular donor or recipient's blood group antigen status. However, recent advances in molecular medicine have led to Conflict-of-interest disclosure: The authors declare no competing financial interests.…”

Plasma cell‐rich acute cellular rejection of a transplanted kidney associated with antibody to the red cell Kidd antigen

“…Interestingly, she was also found to have developed antibodies to the Kidd red‐cell antigen, Jk‐b, which is also present in the kidney. Whereas Jk‐b has previously been reported as a target antigen in the rejection of a renal graft in a single patient, this is the first reported simultaneous occurrence of this antibody and PCAR in a renal transplant recipient (9). The potential relationship between the two events is discussed.…”

Changing Insight to the History of Transplant Surgery

“…Given the case presentation above as well as its pathology, there is a high probability that patient developed acute hemolytic transfusion reaction/ transfusion mediated hyperacute graft rejection both of which represent the type 2 (cytotoxic) hypersensitivity reaction. Even though nowadays recipients are managed with immunosuppressive agents, blood transfusions are usually avoided in those patients because of the risk of acute graft rejection induced by blood transfusion reaction (8). Moreover, if recipient had previous pregnancies/ blood transfusions/ transplantations, he/ she should be tested for preformed antibodies reactive with allogeneic HLA molecules since they can mediate hyperacute graft rejection.…”