ACUTE HEMOLYTIC ANEMIA AFTER LIVER TRANSPLANTATION IN ONE CASE_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

CAO Weigang , QIU Baoan.

Department of Hepatobiliary Surgery, Navy General Hospital, Beijing, 100048, P.R.China.;

Corresponding author：

Keywords：

Liver transplantation; ABO compatibility; Acute hemolytic anemia

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【Abstract】 Objective To report 1 case of acute hemolytic anemia after liver transplantation because of ABO compatibility and therapeutic experience. Methods The patient with liver cancer underwent orthotopic piggyback liver transplantation on September 2010 after radiofrequency ablation of the tumors. The donor and recipient ABO blood types were type O and type A, separately. Acute hemolytic anemia occurred at 10 days after transplantation and hemoglobin decreased to 56 g/L. The bone marrow showed active hyperplasia; and myeboid∶erythroid was 0.52∶1. The immunosuppressants were used and type O washed red blood cells were transfused immediately. Results The general condition of the patient was improved; hemoglobin increased gradually and returned to 111 g/L at 34 days after liver transplantation. At 12 months of follow-up, hemoglobin was within normal range. Conclusion Using graft blood type washed red blood cells transfusion and immunosuppressants could be an effective therapeutic procedure in the patient with ABO compatility graft when acute hemolytic anemia occurrs.

Citation： CAO Weigang,QIU Baoan.. ACUTE HEMOLYTIC ANEMIA AFTER LIVER TRANSPLANTATION IN ONE CASE. Chinese Journal of Reparative and Reconstructive Surgery, 2012, 26(3): 365-367. doi: Copy

1.	Bjøro K, Ericzon BG, Kirkegaard P, et al. Highly urgent liver transplantation: possible impact of donor-recipient ABO matching on the outcome after transplantation. Transplantation, 2003, 75(3): 347-353.
2.	Uribe M, Buckel E, Ferrario M, et al. ABO-incompatible liver transplantation: a new therapeutic option for patients with acute liver failure in Chile. Transplant Proc, 2005, 37(3): 1567-1568.
3.	Urbani L, Mazzoni A, De Simone P, et al. Treatment of antibody-mediated rejection with high-dose immunoglobulins in ABO-incompatible liver transplant recipient. Transpl Int, 2007, 20(5): 467-470.
4.	梁廷波, 汤晓锋, 王伟林, 等. 肝移植中应用ABO血型不合供肝的初步经验. 中华普通外科杂志, 2006, 21(6): 399-402.
5.	Wu A, Bühler LH, Cooper DK. ABO-incompatible organ and bone marrow transplantation: current status. Transplant Int, 2003, 16(5): 291-299.
6.	Ashizawa T, Matsuno N, Yokoyama T, et al. The role of plasmapheresis therapy for perioperative management in ABO-incompatible adult living donor liver transplantation. Transplant Proc, 2006, 38(10): 3629-3632.
7.	Lo CM, Shaked A, Busuttil RW. Risk factors for liver transplantation across the ABO barrier. Transplantation, 1994, 58(5): 543-547.
8.	Fishbein TM, Emre S, Guy SR, et al. Safe transplantation of blood type A2 livers to blood type O recipients. Transplantation, 1999, 67(7): 1071-1073.
9.	Seebach JD, Stussi G, Passwegj R, et al. ABO blood group barrier in allogeneic bone marrow transplantation revisited. Biol Blood Marrow Transplant, 2005, 11(12): 1006-1013.
10.	Takahashi K, Saito K, Takahara S, et al. Excellent long-term outcome of ABO-incompatible living donor kidney transplantation in Japan. Am J Transplant, 2004, 4(7): 1089-1096.
11.	Hanto DW, Fecteau AH, Alonso MH, et al. ABO-incompatible liver transplantation with no immunological graft losses using total plasma exchange, splenectomy, and quadruple immunosuppression: evidence for accommodation. Liver Transpl, 2003, 9(1): 22-30.
12.	Ishida H, Koyama I, Sawada T, et al. Anti-AB titer changes in patients with ABO incompatibility after living related kidney transplantation: survey of 101 cases to determine whether splenectomies are necessary for successful transplantation. Transplantation, 2000, 70(4): 681-685.
13.	Shimazu M, Kitajima M. Living donor liver transplantation with special reference to ABO-incompatible grafts and small-for-size grafts. World J Surg, 2004, 28(1): 2-7.
14.	Nakamura Y, Matsuno N, Iwamoto H, et al. Successful case of adult ABO-incompatible liver transplantation: benefical effects of intrahepatic artery infusion therapy: a case report. Transplant Proc, 2004, 36(8): 2269-2273.
15.	Tanabe M, Shimazu M, Wakabayashi G, et al. Intraportal infusion therapy as a novel approach to adult ABO-incompatible liver transplantation. Transplantation, 2002, 73(12): 1959-1961.
16.	Egawa H, Ohdan H, Haga H, et al. Current status of liver transplantation across ABO blood-type barrier. J Hepatobiliary Pancreat Surg, 2008, 15(2): 131-138.
17.	Yamada Y, Hoshino K, Morikawa Y, et al. Successful liver transplantation across the ABO incompatibility barrier in 6 cases of biliary atresia. J Pediatr Surg, 2006, 41(12): 1976-1979.
18.	Yoshizawa A, Sakamoto S, Ogawa K, et al. New protocol of immunosuppression for liver transplantation across ABO barrier: the use of Rituximab, hepatic arterial infusion, and preservation of spleen. Transplant Proc, 2005, 7(4): 1718-1719.
19.	杨扬, 许赤, 陈颖华, 等. 血型不合肝移植治疗肝功能衰竭. 中华医学杂志, 2007, 87(40): 2833-2836.

1. Bjøro K, Ericzon BG, Kirkegaard P, et al. Highly urgent liver transplantation: possible impact of donor-recipient ABO matching on the outcome after transplantation. Transplantation, 2003, 75(3): 347-353.
2. Uribe M, Buckel E, Ferrario M, et al. ABO-incompatible liver transplantation: a new therapeutic option for patients with acute liver failure in Chile. Transplant Proc, 2005, 37(3): 1567-1568.
3. Urbani L, Mazzoni A, De Simone P, et al. Treatment of antibody-mediated rejection with high-dose immunoglobulins in ABO-incompatible liver transplant recipient. Transpl Int, 2007, 20(5): 467-470.
4. 梁廷波, 汤晓锋, 王伟林, 等. 肝移植中应用ABO血型不合供肝的初步经验. 中华普通外科杂志, 2006, 21(6): 399-402.
5. Wu A, Bühler LH, Cooper DK. ABO-incompatible organ and bone marrow transplantation: current status. Transplant Int, 2003, 16(5): 291-299.
6. Ashizawa T, Matsuno N, Yokoyama T, et al. The role of plasmapheresis therapy for perioperative management in ABO-incompatible adult living donor liver transplantation. Transplant Proc, 2006, 38(10): 3629-3632.
7. Lo CM, Shaked A, Busuttil RW. Risk factors for liver transplantation across the ABO barrier. Transplantation, 1994, 58(5): 543-547.
8. Fishbein TM, Emre S, Guy SR, et al. Safe transplantation of blood type A2 livers to blood type O recipients. Transplantation, 1999, 67(7): 1071-1073.
9. Seebach JD, Stussi G, Passwegj R, et al. ABO blood group barrier in allogeneic bone marrow transplantation revisited. Biol Blood Marrow Transplant, 2005, 11(12): 1006-1013.
10. Takahashi K, Saito K, Takahara S, et al. Excellent long-term outcome of ABO-incompatible living donor kidney transplantation in Japan. Am J Transplant, 2004, 4(7): 1089-1096.
11. Hanto DW, Fecteau AH, Alonso MH, et al. ABO-incompatible liver transplantation with no immunological graft losses using total plasma exchange, splenectomy, and quadruple immunosuppression: evidence for accommodation. Liver Transpl, 2003, 9(1): 22-30.
12. Ishida H, Koyama I, Sawada T, et al. Anti-AB titer changes in patients with ABO incompatibility after living related kidney transplantation: survey of 101 cases to determine whether splenectomies are necessary for successful transplantation. Transplantation, 2000, 70(4): 681-685.
13. Shimazu M, Kitajima M. Living donor liver transplantation with special reference to ABO-incompatible grafts and small-for-size grafts. World J Surg, 2004, 28(1): 2-7.
14. Nakamura Y, Matsuno N, Iwamoto H, et al. Successful case of adult ABO-incompatible liver transplantation: benefical effects of intrahepatic artery infusion therapy: a case report. Transplant Proc, 2004, 36(8): 2269-2273.
15. Tanabe M, Shimazu M, Wakabayashi G, et al. Intraportal infusion therapy as a novel approach to adult ABO-incompatible liver transplantation. Transplantation, 2002, 73(12): 1959-1961.
16. Egawa H, Ohdan H, Haga H, et al. Current status of liver transplantation across ABO blood-type barrier. J Hepatobiliary Pancreat Surg, 2008, 15(2): 131-138.
17. Yamada Y, Hoshino K, Morikawa Y, et al. Successful liver transplantation across the ABO incompatibility barrier in 6 cases of biliary atresia. J Pediatr Surg, 2006, 41(12): 1976-1979.
18. Yoshizawa A, Sakamoto S, Ogawa K, et al. New protocol of immunosuppression for liver transplantation across ABO barrier: the use of Rituximab, hepatic arterial infusion, and preservation of spleen. Transplant Proc, 2005, 7(4): 1718-1719.
19. 杨扬, 许赤, 陈颖华, 等. 血型不合肝移植治疗肝功能衰竭. 中华医学杂志, 2007, 87(40): 2833-2836.

Chinese Journal of Reparative and Reconstructive Surgery

ACUTE HEMOLYTIC ANEMIA AFTER LIVER TRANSPLANTATION IN ONE CASE

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