ABSTRACT
Objective:To explore the prevalence of passenger lymphocyte syndrome(PLS) after liver transplantation, minimize the result bias caused by previous multicenter confounding factors, make up for the lack of statistical analysis of PLS and provide reference for a diagnosis and treatment of PLS after liver transplantation.Methods:We reviewed liver transplants performed in our center from 2018 to 2019, searching for cases with minor ABO incompatibility or bidirectional ABO incompatibility. Diagnostic criteria for PLS: laboratory confirmation included biochemical identifiers of hemolysis, positivity of the direct antiglobul in test(DAT), donor attributed anti-recipient antibody in recipient's sera, and exclusion of other causes of decreased HGB(i.e. postoperative infection, acute rejection & surgical blood loss). A total of 666 liver transplants were performed. Among 52 patients with minor ABO incompatibility or bidirectional ABO incompatibility, 10 cases developed PLS(19.23%)and 42 cases did not(80.77%). Statistical comparisons between patients with and without PLS were performed using the chi-square test and Fisher's exact test.Results:There were no statistically significant differences in PLS group subjects in terms of sex, age, blood group, type of incompatibility, type of immunosuppressants and postoperative outcome. There was statistically significant correlation between postoperative blood transfusion and PLS( P< 0.05), and donor blood group B cohort demonstrated a higher risk of PLS than donor blood group A and O cohorts( P< 0.05). Conclusions:PLS is one of the causes for postoperative anemia in liver transplantation, and donor blood group B graft is a risk factor for PLS.
ABSTRACT
OBJECTIVE@#To analyze serological and molecular characteristics of a case with Bw11 subtype.@*METHODS@#The ABO antigen and antibody in serum were respectively detected with the classical tube method, microcolumn gel method, and absorption and diffusion method. The ABO genotype was determined with PCR using sequence-specific primers (PCR-SSP). Exons 1-7 of the ABO gene were analyzed by Sanger sequencing. Haplotype analysis was carried out for exons harboring variants.@*RESULTS@#Forward and reverse typing with the microcolumn gel method has suggested type O, while forward and reverse typing with the classical tube method yielded inconsistent results. Absorption and diffusion test confirmed presence of B antigen. Antibody screening excluded presence of alloantibodies. The result of PCR-SSP suggested a B/O1 genotype.A 695T>C variant was identified in exon 7 as compared with the B101/O01 allele, which resulted in conversion of Leucine to Proline at position 232, and was confirmed as Bw11/O1 heterozygote.@*CONCLUSION@#The nt695T>C variant probably underlay the weakening of B antigenin the individual. There may be strong anti-B antibodies in Bw11 subtypes. Human-derived and certain monoclonal reagents may not detect Bw11 subtypes which is easy to be misjudged as type O. Application of molecular methods can identify ABO subtypes with accuracy.