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KMID : 0356920200730030252
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Korean Journal of Anesthesiology
2020 Volume.73 No. 3 p.252 ~ p.256
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Seroconversion of red blood cell antibody in ABO-incompatible living donor liver transplantation -a case report-
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Lee Eun-Kyung
Song In-Sun
Kim Gaab-Soo
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Abstract
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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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KEYWORD
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Erythrocytes, Liver transplantation, Plasmapheresis, Red blood cell antibody screen test, Rituximab
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