Seroconversion of Red Blood Cell Antibody in ABO-incompatible Living Donor Liver Transplantation -a Case Report

Overview

Journal Korean J Anesthesiol

Specialty Anesthesiology

Date 2019 Jul 16

PMID 31304695

Authors

Eun Kyung Lee

Insun Song

Gaab Soo Kim

Affiliations

Soon will be listed here.

Abstract

Background: Liver transplantation usually requires blood transfusion, and a red blood cell (RBC) antibody screen is essential for the prevention of a hemolytic reaction. Since proper ABO-compatible grafts are lacking, ABO-incompatible living donor liver transplantation (ABO-i LDLT) with desensitization is a feasible therapy. Desensitization includes intravenous rituximab injection and plasmapheresis before surgery.

Case: A 60-year-old female was diagnosed with hepatitis B virus-related hepatocellular carcinoma and planned for ABO-i LDLT. She tested positive in a RBC antibody screen over two years; however, she tested negative for the test after desensitization. Clinicians noted the seroconversion during induction, and thus, a delay in the preparation of adequate packed RBC was unavoidable.

Conclusions: Even when the latest RBC antibody screen is negative after immunosuppression, clinicians should consider the possibility of a prior positive result to promote safer medical treatment and management.

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