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Original Article
Brief Report
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Volume 341:1504-1507 November 11, 1999 Number 20
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Alloimmune Thrombocytopenia after Organ Transplantation
Kenneth A. West, M.D., David R. Anderson, M.D., Vivian C. McAlister, M.B., Thomas J.C. Hewlett, M.D.C.M., Philip Belitsky, M.D.C.M., James W. Smith, B.Sc., and John G. Kelton, M.D.

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Transplanted organs, particularly livers and kidneys, carry passenger lymphocytes that can transmit autoimmune diseases1 or initiate alloimmune disorders2 in the recipient. We recently treated three unrelated patients who each received an organ (two kidneys and a liver) from the same donor. In all three patients severe alloimmune thrombocytopenia developed as a result of antibodies against the HPA-1a (PLA1) alloantigen. In these three patients the thrombocytopenia was refractory to all medical maneuvers except the transfusion of HPA-1a–negative platelets. In one patient the thrombocytopenia contributed to death. In another, the thrombocytopenia was cured by splenectomy, and in the third patient the . . . [Full Text of this Article]

Case Reports

Organ Donor

Patient 1

Patient 2

Patient 3

Methods

Radioimmunoprecipitation Assay and Typing of Platelets

Detection of Chimerism

Results

Discussion


Source Information

From the Divisions of Nephrology (K.A.W., T.J.C.H.) and Hematology (D.R.A.), Department of Medicine, and the Departments of Surgery (V.C.M.) and Urology (P.B.), Dalhousie University, Halifax, N.S.; and the Division of Hematology, Department of Medicine, McMaster University, and the Canadian Blood Services, Hamilton, Ont. (J.W.S., J.G.K.) — all in Canada.

Address reprint requests to Dr. West at 5087 Dickson Centre, QEII Health Sciences Centre, 5820 University Ave., Halifax, NS B3H 249, Canada, or at kawest@is.dal.ca.

References



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