AUTHOR=Zhao Qianzhe 

TITLE=Case Report: A case of immune hemolytic anemia after liver transplantation: passenger lymphocyte syndrome is the culprit

JOURNAL=Frontiers in Transplantation

VOLUME=Volume 3 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/transplantation/articles/10.3389/frtra.2024.1463325

DOI=10.3389/frtra.2024.1463325

ISSN=2813-2440

ABSTRACT=Passenger lymphocyte syndrome (PLS) is most commonly observed after solid organ transplantation with minor ABO blood group incompatibility. It consists of a set of clinical symptoms brought on by the remaining lymphocytes of the donor organ developing antibodies against the recipient's antigens. Here, we describe a typical case of PLS in a type A+ recipient receiving a liver transplant from a type O+ donor. She suffered from jaundice, abnormally decreased hemoglobin level, and severe hemolytic anemia without bleeding. During hemolysis, we detected a positive direct antiglobulin test (DAT), and the thermal elution test revealed the presence of IgG anti-A antibodies in her serum. When immunosuppressive agents and blood transfusion were used together, cross-matched O+ washing red blood cells led to an expected outcome without side effects.