Abstract:
:Passenger lymphocyte syndrome (PLS) is caused by the transfer of B-lymphocytes present in the donor graft into the recipient circulation following solid organ or hematopoietic stem cell transplantation. These cells may produce antibodies against the recipient's red blood cells, thereby triggering antibody dependent cytotoxicity and erythroid clearance, with potential resulting hemolysis and jaundice. Although uncommon, the true incidence is unknown because many cases are subclinical, with only serologic findings or with non significant levels of hemolysis detectable clinically or by laboratory monitoring. Thus, these cases may not be detected in the immediate perioperative period. No standardized consensus exists on screening for PLS in patients. Through a review of the literature from 2009 to 2019, we aim to approximate the incidence of this condition in different solid organ transplant settings, as well as to streamline recognition, detection, and management of PLS early in the disease course to prevent adverse outcomes and minimize invasive therapy. The resultant literature review yielded 22 case reports and 8 case series comprising 71 solid organ transplant patients. Hematopoietic stem cell transplant cases were excluded, as PLS cases related to solid organ transplant were the primary focus of this review. Our institution has traditionally handled PLS on a case-by-case basis, although we hope to improve this process through an introduction of an algorithm based on review of the literature and formalized communication with primary caregivers.
journal_name
Transfus Med Revjournal_title
Transfusion medicine reviewsauthors
Moosavi MM,Duncan A,Stowell SR,Roback JD,Sullivan HCdoi
10.1016/j.tmrv.2020.06.004subject
Has Abstractpub_date
2020-07-01 00:00:00pages
178-187issue
3eissn
0887-7963issn
1532-9496pii
S0887-7963(20)30033-Xjournal_volume
34pub_type
杂志文章,评审abstract::Low levels of C1 inhibitor, the main inhibitor of the classic complement system, result in paroxysmal angioedema attacks that can be incapacitating or even life-threatening in affected individuals. Molecular defects in the gene for C1 inhibitor cause hereditary angioedema. In recent years, new insights in the pathways...
journal_title:Transfusion medicine reviews
pub_type: 杂志文章,评审
doi:10.1016/j.tmrv.2019.08.002
更新日期:2019-10-01 00:00:00
abstract::Allergic transfusion reactions (ATRs) are the most common adverse reactions occurring during transfusion of blood components. Although most reactions are mild and involve cutaneous manifestations, severe ATRs including life-threatening anaphylaxis may also occur. The mechanisms of ATRs are largely unknown because they...
journal_title:Transfusion medicine reviews
pub_type: 杂志文章,评审
doi:10.1016/j.tmrv.2017.09.002
更新日期:2018-01-01 00:00:00
abstract::An international multidisciplinary panel of 15 experts reviewed 494 published articles and used the RAND/UCLA Appropriateness Method to determine the appropriateness of allogeneic red blood cell (RBC) transfusion based on its expected impact on outcomes of stable nonbleeding patients in 450 typical inpatient medical, ...
journal_title:Transfusion medicine reviews
pub_type: 杂志文章,多中心研究,评审
doi:10.1016/j.tmrv.2011.02.001
更新日期:2011-07-01 00:00:00
abstract::Controversial results exist regarding the clinical benefits of single- vs double-unit umbilical cord blood transplantation (UCBT) in patients with hematologic diseases. A systematic review was conducted to evaluate this issue. The PubMed, Embase, and Cochrane Library databases were searched up to May 2018. A total of ...
journal_title:Transfusion medicine reviews
pub_type: 杂志文章
doi:10.1016/j.tmrv.2018.11.001
更新日期:2019-01-01 00:00:00
abstract::Although remarkable advances have been made in the prevention of the major transfusion-transmitted diseases, long intervals have transpired between the first recognition of transfusion risk and the implementation of a preventive strategy. For hepatitis B virus, that interval was 30 years; for non-A, non-B/hepatitis C ...
journal_title:Transfusion medicine reviews
pub_type: 杂志文章
doi:10.1016/j.tmrv.2008.01.001
更新日期:2008-04-01 00:00:00
abstract::Some have suggested that "blood is different," and the role for cost-effectiveness is thus circumscribed. In this article, the authors start by reviewing key concepts in health economics and economic analysis methods. Examples are drawn from published blood safety studies. After explaining the underlying reasoning beh...
journal_title:Transfusion medicine reviews
pub_type: 杂志文章,评审
doi:10.1016/j.tmrv.2008.09.001
更新日期:2009-01-01 00:00:00
abstract::Until recently, atypical hemolytic uremic syndrome (aHUS), conventionally defined in the pediatric literature as a syndrome of the triad of renal failure, microangiopathic hemolytic anemia, and thrombocytopenia without a prodrome of hemorrhagic diarrhea, has received little attention in adult practice because the pati...
journal_title:Transfusion medicine reviews
pub_type: 杂志文章,评审
doi:10.1016/j.tmrv.2014.08.004
更新日期:2014-10-01 00:00:00
abstract::Cardiac surgical patients are among the highest consumers of allogeneic red blood cells (RBCs) due to the prevalence of anemia and bleeding. Up until recently, there was a paucity of high-quality evidence informing transfusion decisions in this patient group which led to wide variability in transfusion decision making...
journal_title:Transfusion medicine reviews
pub_type: 杂志文章,评审
doi:10.1016/j.tmrv.2017.06.001
更新日期:2017-10-01 00:00:00
abstract::The crossmatch (XM) is an important part of routine pretransfusion testing. It is used to detect ABO incompatibility and other clinically significant antibodies. The XM has been modified many times and, in recent years, has been abbreviated. The 2 common types of XM currently being done are the immediate spin XM for a...
journal_title:Transfusion medicine reviews
pub_type: 杂志文章,评审
doi:10.1016/j.tmrv.2005.08.007
更新日期:2006-01-01 00:00:00
abstract::Population-based investigations suggest that red blood cells (RBCs) are therapeutically effective when collected, processed, and stored for up to 42 days under validated conditions before transfusion. However, some retrospective clinical studies have shown worse patient outcomes when transfused RBCs have been stored f...
journal_title:Transfusion medicine reviews
pub_type: 杂志文章
doi:10.1016/j.tmrv.2014.01.003
更新日期:2014-04-01 00:00:00
abstract::The development and expansion of the CTS in Pittsburgh shows the feasibility of this transfusion medicine delivery system. Few of the changes driven by health care reform both improve patient care and reduce costs. When properly implemented, a CTS achieves these objectives, benefits the community as a whole, and enhan...
journal_title:Transfusion medicine reviews
pub_type: 杂志文章,评审
doi:10.1016/s0887-7963(05)80051-3
更新日期:1995-04-01 00:00:00
abstract::The administration of blood products is a common, resource-intensive, and potentially problem-prone area that may place patients at elevated risk in the clinical setting. Much of the emphasis in transfusion safety has been targeted toward quality control measures in laboratory settings where blood products are prepare...
journal_title:Transfusion medicine reviews
pub_type: 杂志文章,评审
doi:10.1016/j.tmrv.2006.08.007
更新日期:2007-01-01 00:00:00
abstract::The use of prothrombin complex concentrates (PCCs) and fibrinogen concentrates (FIBCs) to achieve hemostasis in the perioperative setting as alternatives to allogeneic blood products remains controversial. To examine the efficacy and safety of PCCs and FIBCs, we conducted a systematic review-in accordance with the Pre...
journal_title:Transfusion medicine reviews
pub_type: 杂志文章,评审
doi:10.1016/j.tmrv.2013.01.002
更新日期:2013-04-01 00:00:00
abstract::Blood services around the world face increasing challenges in recruiting voluntary blood donors. With increasing donor restrictions and ageing populations, it is essential to look for any existing restrictions that may be relaxed in the light of currently available evidence. We propose that one such restriction is the...
journal_title:Transfusion medicine reviews
pub_type: 杂志文章,评审
doi:10.1016/j.tmrv.2010.03.005
更新日期:2010-07-01 00:00:00
abstract::Roger Irving Lee (1881-1964) played significant scientific and leadership roles in overcoming the clinical impediments to blood transfusion in the 1910s. He developed the first successful anticoagulant system, paraffinized glass, and the first sterile system for indirect transfusion without defibrination, the Lee-Vinc...
journal_title:Transfusion medicine reviews
pub_type: 传,历史文章,杂志文章
doi:10.1016/j.tmrv.2004.09.003
更新日期:2005-01-01 00:00:00
abstract::This guideline for the use of immunoglobulin (IG) for sensitized patients undergoing solid organ transplantation (SOT) is an initiative of the Canadian Blood Services and the National Advisory Committee on Blood and Blood Products of Canada to (1) provide guidance for Canadian practitioners involved in the care of pat...
journal_title:Transfusion medicine reviews
pub_type: 杂志文章,评审
doi:10.1016/j.tmrv.2009.09.010
更新日期:2010-01-01 00:00:00
abstract::Hybridoma technology has contributed to virtually all areas of biology and medicine and set the scene for important advances in cell biology and immunodiagnostics. Blood transfusion and transfusion medicine have benefited significantly from development in hybridoma technology, and this has resulted in the generation o...
journal_title:Transfusion medicine reviews
pub_type: 杂志文章,评审
doi:10.1053/tmrv.2002.33436
更新日期:2002-07-01 00:00:00
abstract::With the realization that the skin bleeding time is often an unreliable measure of platelet function, efforts have been made to identify ways to assess qualitative platelet dysfunction. Currently available techniques measure platelet adhesion, platelet aggregation, the ability of platelets to retard or stop flow throu...
journal_title:Transfusion medicine reviews
pub_type: 杂志文章,评审
doi:10.1053/tm.1997.0110106
更新日期:1997-04-01 00:00:00
abstract::Thrombocytopenia affects approximately one fourth of neonates admitted to neonatal intensive care units, and prophylactic platelet transfusions are commonly administered to reduce bleeding risk. However, there are few evidence-based guidelines to inform clinicians' decision-making process. Developmental differences in...
journal_title:Transfusion medicine reviews
pub_type: 杂志文章,评审
doi:10.1016/j.tmrv.2016.05.009
更新日期:2016-10-01 00:00:00
abstract::Quality patient care entails more than simply biomedical interventions. Respect for the wishes, values, and preferences of patients are important elements of quality care. Unique aspects of the beliefs of Jehovah's Witnesses may present physicians with ethical and clinical conflicts. Witnesses believe that allogeneic ...
journal_title:Transfusion medicine reviews
pub_type: 杂志文章,评审
doi:10.1016/j.tmrv.2003.12.004
更新日期:2004-04-01 00:00:00
abstract::Studies of human herpesvirus-8 (HHV-8) transmission through transfusion have produced contradictory results. In North America-a region with a low prevalence of HHV-8 infection-3 studies that tested specimens from linked positive-donor/negative-recipient pairs collected before the introduction of white blood cell (WBC)...
journal_title:Transfusion medicine reviews
pub_type: 杂志文章,评审
doi:10.1016/j.tmrv.2009.09.001
更新日期:2010-01-01 00:00:00
abstract::Autoantibodies against red cells optimally reacting at 0 degree C, ie, CA, are normally found with low titers in the serum of human adults. High-titer CA may be induced by certain infectious agents, including M pneumoniae, EBV, CMV, and rubella virus, or may develop on the basis of chronic (malignant) B cell lymphopro...
journal_title:Transfusion medicine reviews
pub_type: 杂志文章,评审
doi:10.1016/s0887-7963(89)70075-4
更新日期:1989-04-01 00:00:00
abstract::The chromosomal locations of genes controlling the expression of some 200 antigens constituting the 23 established human blood group systems have been reviewed. Twenty-one of the these genes are located on 12 autosomes, and two are located on the X chromosome. Refined chromosomal positions, to a single cytogenetically...
journal_title:Transfusion medicine reviews
pub_type: 杂志文章,评审
doi:10.1016/s0887-7963(98)80056-4
更新日期:1998-07-01 00:00:00
abstract::Several public policy decisions in transfusion medicine require information on the long-term (> or =10-year) survival of transfused patients. This information is needed (1) to estimate the number of surviving transfusion recipients who have contracted a particular infection through transfusion, (2) to assess the cost-...
journal_title:Transfusion medicine reviews
pub_type: 杂志文章,评审
doi:10.1016/s0887-7963(03)00019-1
更新日期:2003-07-01 00:00:00
abstract::Despite significant advancements in the production of platelet products, storage, and transfusion, transfusion refractoriness remains a significant clinical problem, affecting up to 14% of hematological patients receiving platelet transfusions. Human leukocyte antigen (HLA) alloimmunization is a major cause of immune ...
journal_title:Transfusion medicine reviews
pub_type: 杂志文章,评审
doi:10.1016/j.tmrv.2020.09.010
更新日期:2020-10-01 00:00:00
abstract::Two complex protein defense systems-complement and coagulation-are based on amplifying enzyme cascades triggered by specific local stimuli. Excess systemic activation of either system is pathologic and is normally prevented by a family of regulatory proteins. The 2 systems are ancient biological processes which share ...
journal_title:Transfusion medicine reviews
pub_type: 杂志文章,评审
doi:10.1016/j.tmrv.2019.08.004
更新日期:2019-10-01 00:00:00
abstract::A number of molecules on the surface of red blood cells (RBCs) and platelets express antigenic activity. Various biochemical and molecular approaches have been used to determine the structure and possible function that these molecules have for their respective cell types. The existence of variant molecules and null ph...
journal_title:Transfusion medicine reviews
pub_type: 杂志文章,评审
doi:10.1016/j.tmrv.2004.03.006
更新日期:2004-07-01 00:00:00
abstract::The use of blood products to support patients undergoing the large variety of medical and surgical interventions requiring such support has continued to escalate very significantly over time. Relevantly, significant practice variation in the use of blood products exists among practitioners and institutions, largely be...
journal_title:Transfusion medicine reviews
pub_type:
doi:10.1016/j.tmrv.2010.05.002
更新日期:2010-10-01 00:00:00
abstract::The regulation of complement at the surface of cells is mediated by both plasma and membrane proteins. These molecules act in concert to prevent the accelerated catabolism of complement proteins and the concomitant lysis of homologous blood cells. The deficiency of either a plasma or membrane protein predisposes to th...
journal_title:Transfusion medicine reviews
pub_type: 杂志文章,评审
doi:10.1016/s0887-7963(91)70199-5
更新日期:1991-04-01 00:00:00
abstract::Over the last 20 years, the Canadian Blood Services' (CBS) Donor Health Assessment Questionnaire (DHAQ), used to screen prospective blood donors to determine their eligibility, has grown in complexity and length. Its growth is inextricably linked to the evolution of the environment within which CBS operates from unreg...
journal_title:Transfusion medicine reviews
pub_type: 杂志文章,评审
doi:10.1016/j.tmrv.2007.03.002
更新日期:2007-07-01 00:00:00