Alloimmune Thrombocytopenia after Organ Transplantation

Abstract

Transplanted organs, particularly livers and kidneys, carry passenger lymphocytes that can transmit autoimmune diseases1 or initiate alloimmune disorders2 in the recipient. We recently treated three unrelated patients who each received an organ (two kidneys and a liver) from the same donor. In all three patients severe alloimmune thrombocytopenia developed as a result of antibodies against the HPA-1a (PLA1) alloantigen. In these three patients the thrombocytopenia was refractory to all medical maneuvers except the transfusion of HPA-1a–negative platelets. In one patient the thrombocytopenia contributed to death. In another, the thrombocytopenia was cured by splenectomy, and in the third patient the . . .