Underestimated risk of lung transplants researched – 2024-05-04 02:12:00

New findings on life-threatening reactions to donor organs

Vienna (OTS) – As a potentially life-threatening risk in lung transplants, PLS (Passenger Lymphocyte Syndrome) has hardly been researched and is often underestimated in clinical practice. The complication occurs more frequently than previously thought, as a current study at the University Clinic for Transfusion Medicine and Cell Therapy in collaboration with the University Clinic for Thoracic Surgery of MedUni Vienna and Vienna General Hospital shows. The results recently published in the respected “American Journal of Respiratory and Critical Care Medicine” not only provide new insights into PLS, but also approaches for early detection and timely therapy.

The study is the most comprehensive research work on this topic to date. Relevant data and values ​​from around 1,100 patients who received a lung transplant at the University Hospital AKH Vienna between 2010 and 2021 were analyzed. As the results show, PLS occurs significantly more frequently in unequal ABO settings, i.e. with different blood groups of donor and recipient, than previously assumed. PLS occurs when certain white blood cells (lymphocytes) from the donor’s blood trigger hemolysis after the transplant, i.e. destroy the recipient’s red blood cells. Patients with PSL have significantly lower hemoglobin levels, are therefore more anemic and require blood transfusions twice as often as patients without PLS.

High risk for blood group A patients with 0 transplant
“So far it has been assumed that only a few percent of people are affected,” reports study leader Günther Körmöczi (University Clinic for Transfusion Therapy and Cell Therapy). “In our precise analysis of the ABO-unequal transplants, however, it turned out that, depending on the specific blood group combination between donor and recipient, up to 30 percent of patients developed hemolytic reactions after the lung transplant.” Blood group-types were particularly frequently affected. A patients who received blood group 0 transplants.

These findings highlight the urgency of careful monitoring of important parameters after lung transplantation in the ABO-unequal setting in order to detect and treat hemolysis early. The appropriate measures (Coombs test, eluate test) were also described in the study. “Immunohematological monitoring is indicated in ABO-unequal constellations in order to optimally care for patients after the lung transplant and to provide them with an adapted transfusion therapy,” says Körmöczi, emphasizing the relevance of the results. The study is a continuation of the diploma thesis by first author Mirjam M . Kohl (University Clinic for Transfusion Medicine and Cell Therapy) under the supervision of Günther Körmöczi and Stefan Schwarz and thus marks a success not only in research but also in teaching at MedUni Vienna.

Publikation: American Journal of Respiratory and Critical Care Medicine
High Rate of Passenger Lymphocyte Syndrome after ABO Minor Incompatible Lung Transplantation
Mirjam M. Kohl, Stefan Schwarz, Peter Jaksch, Gabriella Muraközy, Martin Kurz, Marlies Schönbacher, Alexander Tolios, Florian Frommlet, Konrad Hoetzenecker, Günther F. Körmöczi

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