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• W2127994703 abstract "Patient: 54-year-old maleChief Complaint: High fever, diarrhea, and skin rashHistory of Present Illness: The patient is blood type group AB, Rh(D) positive with nonalcoholic steatohepatitis (NASH). Due to the advanced nature of his disorder, he received a liver transplant; the donor was group B. The patient received 24 units of blood during and after surgery. Fourteen days post transplant he was discharged. Thirty one days post transplant the patient presented with the current symptoms. Hematology workup revealed pancytopenia with a critically low hemoglobin concentration. The blood bank workup revealed an ABO discrepancy and an apparent auto-anti-E antibody. (Table 1)Past Medical History: The patient has a history of diabetes mellitus. The patient had gastric bypass 25 years prior to the transplant, resulting in a weight loss of 115 pounds. One year ago the patient was diagnosed with NASH.1. What are the patient’s most striking clinical and laboratory findings?2. What is the nature of the ABO discrepancy?3. What is the most likely cause of the intravascular hemolysis?4. Is hemolytic anemia an unexpected complication of transplants?5. What is the immunological basis for this condition?6. What is the appropriate blood component therapy for this patient?1. The most striking clinical findings of the patient were fever, diarrhea, and skin rash. These are indications of graft versus host disease (GVHD), a complication that is rarely seen after orthotopic liver transplantation.1 Acute GVHD occurs between 1 and 8 weeks after the transplant. Symptoms may include fever, diarrhea, and skin rash. Diarrhea is due to lymphocyte infiltration and destruction of the intestinal mucosa, leading to a loss of absorptive function.1 Pancytopenia is associated with GVHD in many cases. The neutropenia and thrombocytopenia may lead to a life-threatening infection.1 A skin biopsy of this patient was consistent with GVHD.The Hemoglobin …" @default.
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• W2127994703 date "2011-03-01" @default.
• W2127994703 modified "2023-09-27" @default.
• W2127994703 title "ABO Discrepancy and Hemolytic Anemia Post Liver Transplant due to Passenger Lymphocyte Syndrome" @default.
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• W2127994703 doi "https://doi.org/10.1309/lm1gtbkkwr2v2ggh" @default.
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