• antibody-mediated rejection;
  • pediatric liver transplantation;
  • plasmapheresis;
  • humoral rejection

Martin T, Schwartz J, Demetris A, Comstock J, Lowichik A, Book L. Plasmapheresis treatment of antibody-mediated rejection in an A2 donor to O pediatric liver transplant recipient. Pediatr Transplantation 2011: 15:E15–E18. © 2009 John Wiley & Sons A/S.

Abstract:  It is safe to transplant kidneys from blood group A2 donors into O recipients if the latter have low titers of anti-A antibodies. However, in liver transplantation, O and B recipients of A2 donor livers are not routinely screened for anti-blood group antibodies because of the immuno-absorptive capacity of the liver and the low incidence of antibody-mediated rejection. Herein, we report a rare case of combined cell and antibody-mediated rejection in a pediatric blood group O recipient of an A2 donor liver, and rescue of the allograft using PP and IVIG.