Abstract：
Passenger lymphocyte syndrome (PLS) is a rare post solid organ transplantation complication, usually occurring after ABO- or Rh-mismatched transplantation. In general, PLS can lead to severe hemolytic anemia, but it is usually a self-limited disease. Most PLS cases start with a decreased hemoglobin (Hb) level and require donor type RBC transfusion as the only treatment.
In our case, the allograft was given by an O-type Rh-D(+) donor and received by an A-type Rh-D(+) recipient. The PLS was developed on the post-operative day (POD) 10 with an increased indirect bilirubin (IDBIL) level as the first clinical symptom, while the Hb level did not significantly decrease. The PLS was diagnosed on POD 17 by a direct antiglobulin test (DAT) and a blood group test. The patient quickly became stable on POD 18 after a total of eight units of O-type RBC transfusion. Kidney function was uneventful in the entire PLS period.
In ABO-mismatched kidney transplantation, an increased level of IDBIL should be considered as the first symptom of PLS even without an Hb decrease. The kidney function may be not affected by the PLS symptoms.
In our case, the allograft was given by an O-type Rh-D(+) donor and received by an A-type Rh-D(+) recipient. The PLS was developed on the post-operative day (POD) 10 with an increased indirect bilirubin (IDBIL) level as the first clinical symptom, while the Hb level did not significantly decrease. The PLS was diagnosed on POD 17 by a direct antiglobulin test (DAT) and a blood group test. The patient quickly became stable on POD 18 after a total of eight units of O-type RBC transfusion. Kidney function was uneventful in the entire PLS period.
In ABO-mismatched kidney transplantation, an increased level of IDBIL should be considered as the first symptom of PLS even without an Hb decrease. The kidney function may be not affected by the PLS symptoms.
摘要：
背景：乘客淋巴细胞综合征（PLS）是一种罕见的实体器官移植后并发症，通常发生在ABO或Rh错配移植后。总的来说,PLS会导致严重的溶血性贫血,但它通常是一种自限性疾病。大多数PLS病例以血红蛋白（Hb）水平降低开始，需要供体型红细胞输血作为唯一的治疗方法。
方法：在我们的例子中，同种异体移植物由O型Rh-D(+)供体给予,并由A型Rh-D(+)受体接受.PLS在术后第10天（POD）发展，以间接胆红素（IDBIL）水平升高为第一临床症状，而Hb水平没有显著降低。通过直接抗球蛋白测试（DAT）和血型测试在POD17上诊断出PLS。在总共8个单位的O型红细胞输注后，患者在POD18上迅速变得稳定。整个PLS期间肾功能平稳。
结论：在ABO不匹配的肾移植中，即使没有Hb降低,IDBIL水平升高也应被视为PLS的首发症状.肾功能可能不受PLS症状的影响。
方法：在我们的例子中，同种异体移植物由O型Rh-D(+)供体给予,并由A型Rh-D(+)受体接受.PLS在术后第10天（POD）发展，以间接胆红素（IDBIL）水平升高为第一临床症状，而Hb水平没有显著降低。通过直接抗球蛋白测试（DAT）和血型测试在POD17上诊断出PLS。在总共8个单位的O型红细胞输注后，患者在POD18上迅速变得稳定。整个PLS期间肾功能平稳。
结论：在ABO不匹配的肾移植中，即使没有Hb降低,IDBIL水平升高也应被视为PLS的首发症状.肾功能可能不受PLS症状的影响。
