Korean J Anesthesiol.  2020 Jun;73(3):252-256. 10.4097/kja.19141.

Seroconversion of red blood cell antibody in ABO-incompatible living donor liver transplantation -a case report-

  • 1Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyungkwan University School of Medicine, Seoul, Korea


; Liver transplantation usually requires blood transfusion, and a red blood cell (RBC) antibody screen is essential for the prevention of a hemolytic reaction. Since proper ABO-compatible grafts are lacking, ABO-incompatible living donor liver transplantation (ABO-i LDLT) with desensitization is a feasible therapy. Desensitization includes intravenous rituximab injection and plasmapheresis before surgery. Case: A 60-year-old female was diagnosed with hepatitis B virus-related hepatocellular carcinoma and planned for ABO-i LDLT. She tested positive in a RBC antibody screen over two years; however, she tested negative for the test after desensitization. Clinicians noted the seroconversion during induction, and thus, a delay in the preparation of adequate packed RBC was unavoidable.
Even when the latest RBC antibody screen is negative after immunosuppression, clinicians should consider the possibility of a prior positive result to promote safer medical treatment and management.


Liver transplantation; Plasmapheresis; Red blood cell antibody screen test; Rituximab
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