Prospective evaluation of immune haemolysis in liver transplantation.

Autor: Brunetta DM; Hospital Universitario Walter Cantidio, Fortaleza, Brazil.; Centro de Hematologia e Hemoterapia do Ceara, Fortaleza, Brazil.; Department of Surgery, Universidade Federal do Ceara, Fortaleza, Brazil., de Barros Carlos LM; Centro de Hematologia e Hemoterapia do Ceara, Fortaleza, Brazil., Da Silva VFP; Centro de Hematologia e Hemoterapia do Ceara, Fortaleza, Brazil., de Oliveira Alves TM; Centro de Hematologia e Hemoterapia do Ceara, Fortaleza, Brazil., Macedo ÊS; Department of Internal Medicine, Universidade Federal do Ceara, Fortaleza, Brazil., Coelho GR; Hospital Universitario Walter Cantidio, Fortaleza, Brazil.; Department of Surgery, Universidade Federal do Ceara, Fortaleza, Brazil., Vasconcelos JBM; Hospital Universitario Walter Cantidio, Fortaleza, Brazil.; Department of Surgery, Universidade Federal do Ceara, Fortaleza, Brazil., De Francesco Daher E; Hospital Universitario Walter Cantidio, Fortaleza, Brazil.; Department of Internal Medicine, Universidade Federal do Ceara, Fortaleza, Brazil., Garcia JHP; Hospital Universitario Walter Cantidio, Fortaleza, Brazil.; Department of Surgery, Universidade Federal do Ceara, Fortaleza, Brazil.
Jazyk: angličtina
Zdroj: Vox sanguinis [Vox Sang] 2020 Jan; Vol. 115 (1), pp. 72-80. Date of Electronic Publication: 2019 Nov 13.
DOI: 10.1111/vox.12865
Abstrakt: Background: Immune haemolysis in liver transplant (LT) can occur due to autoantibodies and alloantibodies. The aim of this study was to evaluate the prevalence and risk factors for immune haemolysis in LT.
Methods: A total of 175 consecutive patients were included. Multiorgan recipients were excluded. Samples, from before LT, seven consecutive days and weekly for 4 weeks, were evaluated for haemolysis and immunohaematological tests. SPSS 24 was used for statistical analysis.
Results: Nine patients (5·1%) presented positive antibody screen (AS) before LT, (2·3% clinically significant), more frequent in RhD-negative (P = 0·017). Positive DAT occurred in 53 (30·3%) and was related to high MELD score (P = 0·048), HCV (P = 0·005) and furosemide use (P = 0·001). Positive AS after LT occurred in 22 patients (12·5%), with nine (5·7%) clinically significant antibodies. Positive AS occurred more frequently in RhD negative (P = 0·021) and in those transfused (P = 0·022). Post-transplant positive DAT was associated with piperacillin-tazobactam use (P = 0·021) and minor ABO incompatibility (P = 0·0038). Five patients presented passenger lymphocyte syndrome (PLS), all received liver-graft O, four presented haemolysis, and three were transfused due to PLS.
Conclusion: Auto- and alloantibodies against red blood cell antigens are frequent in LT, but the frequency of immune haemolysis was only 2·8%. The only risk factor for PLS was minor ABO mismatch.
(© 2019 International Society of Blood Transfusion.)
Databáze: MEDLINE
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