Passenger Lymphocyte Syndrome in a Renal Transplant Recipient-A Case Report

Background: Passenger lymphocyte syndrome (PLS) is an immune-mediated hemolysis that usually occurs after a minor ABO mismatched solid organ transplant. The occurrence of PLS is far less in renal transplant recipients than in other solid organ transplants.

Case presentation: We report a case of a 35-year-old male (A –ve) underwent renal transplant with his mother (O +ve) as donor and developed passenger lymphocyte syndrome. His post-transplant period was uneventful and attained normal graft function on day 5. Around 10 days after transplant, our patient showed a rapid fall in blood haemoglobin level and clinical jaundice. Direct coombs test and anti-A antibody titre done was positive confirming a diagnosis of PLS. He was stabilised with packed cell transfusion and his immunosuppression was changed to tacrolimus from cyclosporine. His condition improved with supportive measures and he was on follow-up for one year with normal creatinine and haemoglobin levels. However, later he died of fungal sepsis with functioning renal allograft.

Conclusion: PLS is an important complication than occurs increasingly minor non-ABO mismatch transplants. Early diagnosis and appropriate treatment are important in at risk individuals.

Author(s): Arul R, Dhanapriya J, Dinesh KT, Sakthirajan R, Balasubramaniyan T and Gopalakrishnan N  

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