Red cell antibody problems in 1000 liver transplants

G. Ramsey*, F. W. Cornell, L. F. Hahn, P. Larson, L. B. Issitt, T. E. Starzl

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

48 Scopus citations

Abstract

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. 1989 AABB

Original languageEnglish (US)
Pages (from-to)396-400
Number of pages5
JournalTransfusion
Volume29
Issue number5
DOIs
StatePublished - Jun 1989

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Hematology

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