Gm Allotyping to Determine the Origin of Red Cell Antibodies in
Recipients of Solid Organ Transplants

Swanson, Jane L.; Sastamoinen, Robert; Steeper, Theresa A.; Sebring, Elizabeth S.

doi:10.1159/000461614

Cited by 4 publications

(5 citation statements)

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“…IgG allotyping has demonstrated the donor origin of such antibodies from liver and renal transplants. 27,28 We found no non-ABO antibodies of graft origin and no Rh immunization attributable to Rh-incompatible grafts, both of which have been observed after renal transplantation. [29][30][31][32][33] The extensive blood needs of liver transplant patients are frequently complicated by a diverse range of RBC antibody problems.…”

Section: Discussionmentioning

confidence: 67%

Red cell antibody problems in 1000 liver transplants

et al. 1989

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Liver transplant patients frequently require large amounts of blood. The frequency and nature of their red cell (RBC) antibody problems were examined. Records were reviewed in 496 adults and 286 children undergoing 1000 consecutive transplants. Twenty-two percent of adults and 14 percent of children had RBC alloantibodies. Antibodies of potential clinical significance were found before transplant in 6.3 percent of adults and 1.0 percent of children; despite immunosuppression, they appeared 1 to 5 weeks after transplant in an additional 7.5 and 5.2 percent respectively. These antibodies probably represented secondary immune responses. Of 58 transplant patients with prior potentially significant antibodies, 8 required 7 to 110 units of antigen-untyped blood after 8 to 28 units of antigen-negative blood; of these patients, one had subsequent hemolysis. Positive direct antiglobulin tests in 24 percent of adults and 10 percent of children were most often thought to be due to nonspecific adsorption of IgG. Anti-recipient ABO antibodies developed in 22 of 60 (37%) evaluable ABO-unmatched grafts; 13 cases had associated hemolysis. In all, 36 percent of adults and 20 percent of children had diverse RBC antibody problems. Resolution of these problems is an important part of the laboratory support necessary for a liver transplantation program.The Blood Bank plays an important role in the supportive care of liver transplant patients before, during, and after surgery. Before transplant for end-stage liver disease, patients are often transfused for bleeding due to portal hypertension, esophageal varices, deficient coagulation factors, thrombocytopenia, or other surgery. After transplant, many patients need further transfusions and some require retransplantation. The liver transplant program at the University of Pittsburgh has the world's largest such experience, and since the program's inception in 1981, its overall perioperative and postoperative blood use has been carefully documented.1 -5 These patients have ample opportunity for red cell (RBC) alloimmunization.The purpose of this study was to examine all RBC antibody problems encountered in 1000 consecutive liver transplants performed in our center from February 1981 to February 1987. Previously, as part of an examination of the relationship of the HLA system to RBC alloimmunization, 6 we reported a 9.5 percent frequency of potentially significant RBC alloantibodies in 263 adults. We present here our cumulative experience in both adults and children with regard to 1) the overall frequencies of RBC antibodies; 2) the onset and duration of significant RBC antibodies relative to transplant immunosuppression; 3) the cases in which insufficient compatible blood was available for surgery; and 4) the frequencies and causes of © J. B. Lippincott Co.

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Section: Discussionmentioning

confidence: 67%

Red cell antibody problems in 1000 liver transplants

et al. 1989

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“…These patients received cyclosporine and prednisone immunosuppres sion. However, the kidney recipient described in this report was treated with antilymphocyte globulin, predni sone, and azathioprine; but not cyclosporine, which has been implicated in most reported cases of posttransplan tation hemolysis [6][7][8][9][10][11][12][13][14][15][16][17].…”

Section: Methodsmentioning

confidence: 99%

“…The ABO and Rh alloantibodies detected after trans plantation have been assumed to be made by passenger lymphocytes transplanted with the donor organ [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] and one example was shown to be donor derived by Gm typing [17], Gm typing was useful in the case now described since the mother's Gm typing was not identical to her son's and the antibody found in the posttransplan tation serum was clearly of maternal origin. The limited Gm type of the posttransplantation antibody is consistent with clonal proliferation of a limited number of passenger lymphocytes, or it may be due to an insufficient amount of antibody IgG present to 'coat' the RBCs in the test system.…”

Section: Methodsmentioning

confidence: 99%

“…Alloantibodies of A, B, and Rh specificity directed at the patient's red cells (RBCs) have been found in the posttransplantation sera and on the RBCs of many recipients of solid organ transplants [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17], Most of these antibodies were assumed to be derived from viable donor B lymphocytes introduced at the time of transplantation. One anti-Ai was shown to be of donor origin by Gm allotyping [17], This report will describe the use of Gm allotyping to determine the source of the anti-D causing mild hemolytic anemia in the recipient of a maternal kidney transplant.…”

Section: Introductionmentioning

confidence: 99%

“…One anti-Ai was shown to be of donor origin by Gm allotyping [17], This report will describe the use of Gm allotyping to determine the source of the anti-D causing mild hemolytic anemia in the recipient of a maternal kidney transplant.…”

Section: Introductionmentioning

confidence: 99%

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Gm Allotyping to Determine the Origin of the Anti-D Causing Hemolytic Anemia in a Kidney Transplant Recipient

Swanson¹,

Sebring²,

Sastamoinen³

et al. 1987

Vox Sanguinis

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Anti-D causing mild hemolytic anemia was found in the serum and on the red cells of a D-positive patient who had received a kidney transplant from his D-negative mother. Anti-D had been detected in the donor’s serum before transplantation. Gm allotyping of the patient’s serum, donor’s serum, donor’s anti-D, and the unexpected anti-D in the posttransplantation serum showed the antibody to be of maternal origin. The patient was Gm(fb), the donor Gm(agfb), the maternal anti-D Gm (afb), and the anti-D in the posttransplantation serum was Gm(a).

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Immune-mediated hemolysis in a postoperative patient Case report: anti-U and differential diagnosis

Womack²,

Sg³

1993

Immunohematology

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We present the differential diagnosis for a Coombs-positive immune hemolysis having onset during hospitalization and, in particular, during the postoperative period. The stimulus for this article was a delayed hemolytic transfusion reaction (DHTR) due to anti-U following open-heart surgery. The initial clinical and serologic findings led us to consider other causes of immune hemolysis which are reviewed in this article. To our knowledge, this is the fourth case of a DHTR due to anti-U to be reported in the medical literature. ImmunohematoIogv 1993;9:41-46.

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Gm Allotyping to Determine the Origin of Red Cell Antibodies in Recipients of Solid Organ Transplants

Cited by 4 publications

References 0 publications

Red cell antibody problems in 1000 liver transplants

Red cell antibody problems in 1000 liver transplants

Gm Allotyping to Determine the Origin of the Anti-D Causing Hemolytic Anemia in a Kidney Transplant Recipient

Immune-mediated hemolysis in a postoperative patient Case report: anti-U and differential diagnosis

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