Journal article

Lessons and Insights From ABO-Incompatible Lung Transplantation

GI Snell, M Holmes, BJ Levvey, A Shipp, C Robertson, GP Westall, S Cohney

American Journal of Transplantation | WILEY-BLACKWELL | Published : 2013


With ABO blood group incompatibility (ABOi) between donor and recipient becoming a part of mainstream living-donor renal transplantation, the applicability of ABOi to other areas of transplantation is being reconsidered. Here we present a case of inadvertent ABOi lung retransplantation managed successfully with initial plasmapheresis, antithymocyte globulin and intravenous immunoglobulin; and subsequently with oral cyclophosphamide and sirolimus in addition to tacrolimus and prednisolone. Interestingly, in the setting of solid levels of tacrolimus and sirolimus, the patient developed a fatal thrombotic microangiopathy of uncertain origin subsequent to the cessation of cyclophosphamide at 9 y..

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