Autoimmune hemolytic anemia due to antibody formation against the A or B antigen in renal transplant recipitents has been reported on rare occasions. We experienced a case of autoimmune hemolytic anemia which developed 11 days after renal
transplantation during CsA and prednisolone administration as immunosuppressive agents. The patient was a 46 year old male, blood group was Rh(+) A, who had received a kidney from his Rh(+) O, HLA haplotype identical elder brother. He was
transfused
with three units of Rh(+) A RBCs preoperatively and his hemoglobin level was 9.2g/dl 1 day after transplantation. After 11 to 12 days posttransplantation, the hemoglobin level dropped to 3.8g/dl. A peripheral blood smear showed marked
spherocytosis
and
polychromatophilia. The reticulocyte count was increased to 4.2%, and total bilirubin was increased to 2.91mg/dl. The LDH was raised to 561 IU/L and the plasma Hb level was 6.5mg/dl. Blood bank tests confirmed that the autoantibody cause
hemolytic
anemia was anti-A. If transplant recipients of blood groups A, B, or AB, who receive organs from blood group 0 donors, have hemolytic anemia and ABO discrepancy, the possibility of AIHA due to anti-A or anti-B should be considered.
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