SANUM: Revista Científico-Sanitaria / Scientific-Health Journal
Published July 29, 2026 | Version v1
Journal article Open

SOSPECHA DE MICROQUIMERISMO POSTRASPLANTE EN EL CONTEXTO DE SÍNDROME DEL LINFOCITO PASAJERO: A PROPÓSITO DE UN CASO.

Authors/Creators

  • 1. Grupo Interinstitucional de Medicina Interna (GIMI1), Universidad Libre, Cali, Colombia
  • 2. Servicio de Gastroenterología y Hepatología, Centro Médico Imbanaco, Cali, Colombia.

Description

Tipo de artículo: Caso clínico

Antecedentes: El trasplante hepático es el tratamiento definitivo para la enfermedad hepática terminal y neoplasias hepáticas. En el contexto de la escasez de donantes, los trasplantes con incompatibilidad menor ABO son frecuentes y pueden asociarse a complicaciones inmunológicas como el síndrome del linfocito pasajero (SLP), una causa poco común de anemia hemolítica en el periodo postoperatorio temprano.

Resumen del caso: Se presenta un hombre de 75 años con cirrosis por hepatitis B y hepatocarcinoma, grupo sanguíneo A Rh negativo, quien recibió un trasplante hepático de donante O Rh positivo. Al séptimo día postoperatorio desarrolló anemia hemolítica con prueba de antiglobulina directa positiva, elevación de lactato deshidrogenasa, reticulocitosis e hiperbilirrubinemia indirecta. Se documentaron anticuerpos anti-A1 y discrepancia en el grupo ABO, compatibles con síndrome del linfocito pasajero. Recibió manejo con corticosteroides e intensificación de la inmunosupresión, con evolución favorable y sin recurrencia.

Conclusiones: El síndrome del linfocito pasajero debe sospecharse en pacientes con anemia temprana posterior a trasplante hepático, especialmente en presencia de incompatibilidad ABO. Su reconocimiento oportuno permite un manejo adecuado y plantea la posible asociación con microquimerismo y tolerancia inmunológica del injerto.

Abstract (English)

Article type: Clinical case

Background: Liver transplantation is the definitive treatment for end-stage liver disease and liver malignancies. Due to donor shortages, ABO minor mismatched transplants are increasingly performed and may be associated with immunological complications such as passenger lymphocyte syndrome (PLS), an uncommon cause of early post-transplant hemolytic anemia.

Case summary: We report a 75-year-old man with hepatitis B-related cirrhosis and hepatocellular carcinoma, blood type A Rh negative, who received a liver transplant from an O Rh positive donor. On postoperative day seven, he developed hemolytic anemia with a positive direct antiglobulin test, elevated lactate dehydrogenase, reticulocytosis, and indirect hyperbilirubinemia. Anti-A1 antibodies and ABO discrepancy were identified, consistent with passenger lymphocyte syndrome. He was treated with corticosteroids and intensified immunosuppression, with favorable evolution and no recurrence.

Conclusions: Passenger lymphocyte syndrome should be suspected in patients with early hemolytic anemia after liver transplantation, particularly in ABO mismatch settings. Early recognition allows appropriate management and suggests a potential association with microchimerism and graft immune tolerance.

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Additional details

Additional titles

Translated title (English)
SUSPECTED POST-TRANSPLANT MICROCHIMERISM IN THE CONTEXT OF PASSENGER LYMPHOCYTE SYNDROME: A CASE REPORT.

Dates

Collected
2026-05-18
manuscrito recibido
Accepted
2026-06-20
evaluación doble ciego
Available
2026-07-29
publicación en número de la revista

Software

Repository URL
https://revistacientificasanum.com/

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