Passenger lymphocyte syndrome after liver transplantation in a blood group AB recipient with a blood group A donor: a case report

Abstract

Objective To explore the laboratory monitoring procedure and its clinical significance in patients with passenger lymphocyte syndrome after liver transplantation. Methods The Hb and bilirubin levels were monitored in one AB blood type patient post-liver transplantation. The ABO blood group type, unexpected antibody screening test, direct anti-globulin test and acid elution test were performed respectively in blood samples of the patient to identify the serum antibodies and erythrocyte membrane sensitized antibodies. Results The patent’s Hb level showed a decreasing trend on the day 11 post-operation, reaching the lowest level of 62 g/L on day 17, and his serum bilirubin increased. The patient’s ABO blood type was determined as AB while anti-B antibody was detected in the patient’s serum. The direct anti-globulin test was weakly positive, while the unexpected antibody screening test was negative. Anti-B antibody was detected in the elution and the patient’s serum. The patient′s serum was incompatible with type AB and type B erythrocytes in the cross-matching test, while it was compatible with type A and type O erythrocytes. Conclusion Through monitoring serum anti-A, anti-B and direct anti-human globulin test, the patients with passenger lymphocyte syndrome after liver transplantation can be early diagnosed and the prognosis can be improved.

Keywords

• passenger lymphocyte syndrome
• liver transplantation
• non-phenotype
• hemolysis