en
Scientific article
English

Factors associated with immune hemolytic anemia after pediatric liver transplantation

Published inPediatric Transplantation, vol. 22, no. 5, e13230
Publication date2018
Abstract

Immune-mediated hemolytic anemia following SOT is a rare disorder, the risk factors for which are unknown. Our purpose was to analyze a seemingly increased incidence in our center with the aim to identify predisposing factors. This recipients single-center retrospective study reviewed the medical records of 96 pediatric LT between 2000 and 2013. IHA was defined as acute anemia with a positive direct antiglobulin test. Seven cases of immune-mediated hemolytic anemia were identified (incidence 8.5%). Three cases presented during the first 3 months following LT (early IHA), and 4 presented later (late IHA). All patients with late IHA required rituximab. Using univariate analysis, the following factors were associated with IHA onset: BA (P = .04), younger age (P = .04), and the use of IGL-1 preservation solution (P = .05). Late IHA was associated with viral infections occurring beyond 3 months following LT, younger age, and BA (P = .01). Overall, CMV infection was associated with the development of both early and late IHA: CMV-negative recipients who received an organ from a CMV-positive donor were more likely to develop IHA (P = .035), and de novo CMV infection during the first year post-LT was associated with late IHA (P = .03). IHA is a rare complication following pediatric LT, occurring more frequently in younger patients and patients with an initial diagnosis of BA. CMV-negative recipients and patients who experience a de novo CMV infection in the first year following LT seem particularly vulnerable. IGL-1 preservation solution may be associated with an increased likelihood of developing IHA, a novel finding which warrants further investigation.

Keywords
  • Anemia
  • Hemolytic
  • Autoimmune/diagnosis/epidemiology/etiology
  • Child
  • Child
  • Preschool
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Infant
  • Liver Transplantation
  • Male
  • Outcome Assessment (Health Care)
  • Postoperative Complications/diagnosis/epidemiology/etiology
  • Retrospective Studies
  • Risk Factors
  • Evans syndrome
  • Anemia
  • Autoimmune
  • Autoimmunity
  • Hemolytic
  • Liver transplantation
  • Pediatrics
Citation (ISO format)
ROCK, Nathalie et al. Factors associated with immune hemolytic anemia after pediatric liver transplantation. In: Pediatric Transplantation, 2018, vol. 22, n° 5, p. e13230. doi: 10.1111/petr.13230
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Article (Published version)
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Identifiers
ISSN of the journal1397-3142
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Creation11/06/2019 9:25:00 AM
First validation11/06/2019 9:25:00 AM
Update time03/15/2023 6:40:06 PM
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