Donor origin Rh antibodies as a cause of significant hemolysis following ABO-identical orthotopic liver transplantation

A group A, D-positive patient underwent orthotopic liver transplantation from a group A, D-negative (cde/cde)donor. Anti-D and -E were eluted from the recipient’s red cells and were found in the recipient’s serum 13 days later, at which time significanthemolysis developed. These Rh antibodies appear to he secondary to p a s sive transfer of sensitized d o n o r lymphocytes, a rare finding following liver transplantation.