Living donor liver transplantation in a recipient with anti-Fy(a) and Jk(a) antibodies

Hepatogastroenterology. 2005 Mar-Apr;52(62):610-2.

Abstract

We report a case of a living donor liver transplantation using right lobe graft to a recipient having anti-Fy(a) and Jk(a) antibodies. The red blood cell (RBC) antigens of the donor were Fy (a+) and Jk (a-). We attempted to eliminate donor RBCs remaining in the graft by perfusing histidine-tryptophan-ketoglutarate. Further, Fy (a-)/Jk (a-) RBC concentrates were transfused during the operation. However, the anti-Fy(a) titer increased approximately 8-fold on the seventh postoperative day. On the same day, serum levels of transaminase and total bilirubin increased presumably due to acute cellular rejection. Steroid administration immediately reduced levels of transaminase, total bilirubin and anti-Fy(a) titer. The increase of anti-Fy(a) titer may be due to a secondary immune response to the donor's Fy(a) antigen on RBCs remaining in the graft.

Publication types

  • Case Reports

MeSH terms

  • Bilirubin / blood
  • Blood Group Antigens / immunology*
  • Duffy Blood-Group System / immunology*
  • Erythrocyte Transfusion
  • Humans
  • Isoantibodies / blood*
  • Liver Cirrhosis / immunology*
  • Liver Cirrhosis / surgery*
  • Liver Transplantation*
  • Living Donors*
  • Male
  • Middle Aged
  • Postoperative Period
  • Preoperative Care
  • Receptors, Cell Surface / immunology*
  • Time Factors
  • Transaminases / blood

Substances

  • ACKR1 protein, human
  • Blood Group Antigens
  • Duffy Blood-Group System
  • Isoantibodies
  • Receptors, Cell Surface
  • Transaminases
  • Bilirubin