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Zhao H, Ding Z, Luo Z, Liu H, Peng P, Wang X, Jia Q, Yang Z. Passenger lymphocyte syndrome in renal transplantation: A systematic review of published case reports. Transpl Immunol 2022; 73:101605. [PMID: 35487476 DOI: 10.1016/j.trim.2022.101605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/18/2022] [Accepted: 04/21/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Passenger lymphocyte syndrome (PLS) is an immune-mediated hemolysis that occurs after ABO-mismatched kidney transplantation. PLS is caused by donor lymphocytes producing antibodies to recipient red blood cells, resulting in hemolysis. The incidence of PLS has been reported to be approximately 20% in patients with ABO-mismatched groups. Nevertheless, there is no comprehensive review of PLS following renal transplantation. In this review, we systematically summarized the data of patients with PLS after renal transplantation to help clinicians diagnose and treat more effectively. METHODS A systematic review was conducted using PubMed, Embase, and Web of Science. All relevant data were collected, including age, sex, and clinical and immune parameters. RESULTS A total of 91 published cases were identified. The age ranged from 9 to 70 years old and 58.2% were male. Eighty-six cases were only kidney transplantations, one was liver-kidney transplantation, three were pancreas-kidney transplantations, and one was intestinal-kidney transplantation. Of these cases, 27 received kidneys from deceased donors, whereas 40 received kidneys from living donors. Most patients showed immune hemolysis dominated by anaemia, which was significantly improved after symptomatic support treatment, such as blood transfusion and erythropoietin injection. CONCLUSION PLS is an immune-mediated disease that can occur in patients with ABO-mismatched renal transplantation, which commonly causes hemolysis, although death or deformities of the graft can also occur in patients with the disorder. Symptomatic supportive treatment is an effective treatment scheme at present, but more effective treatment and prevention schemes still need to be explored.
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Affiliation(s)
- Hang Zhao
- Peking University China-Japan Friendship School of Clinical Medicine, Beijing, China; China-Japan Friendship Hospital, Yinghuadong Road, Beijing 100029, Chaoyang District, China
| | - Zhenshan Ding
- China-Japan Friendship Hospital, Yinghuadong Road, Beijing 100029, Chaoyang District, China; Peking University China-Japan Friendship School of Clinical Medicine, Beijing, China
| | - Zhenkai Luo
- Graduate School of Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China; Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hailong Liu
- Department of Joint Surgery, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Panxin Peng
- Cancer Hospital Chinese Academy of Medical Sciences, Shenzhen Center, Baohe Road, Shenzhen 518000, Longgang District, China
| | - Xuming Wang
- Peking University China-Japan Friendship School of Clinical Medicine, Beijing, China; China-Japan Friendship Hospital, Yinghuadong Road, Beijing 100029, Chaoyang District, China
| | - Qiang Jia
- Peking University China-Japan Friendship School of Clinical Medicine, Beijing, China; China-Japan Friendship Hospital, Yinghuadong Road, Beijing 100029, Chaoyang District, China
| | - Zhihao Yang
- Peking University China-Japan Friendship School of Clinical Medicine, Beijing, China; China-Japan Friendship Hospital, Yinghuadong Road, Beijing 100029, Chaoyang District, China.
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