Indicators of clinically significant red cell antibodies produced by sensitized lymphocytes in liver transplant patients

It has been documented that transplanted livers can carry sensitized lymphocytes that subsequently produce red cell antibodies. We evaluated immunohematological variables in liver donors and recipients for indicators that might be predictive of serological red blood cell (RBC) destruction mediated by the passenger lymphocytes. Organ donor sera with antibody scores greater than (>) 60 correlated with a positive direct antiglobulin test (DAT) and need for increased RBC transfusion in liver transplant recipients. We therefore propose an antibody screen on all potential liver donors and titration of unexpected alloantibodies; titration of ABO antibodies of liver donors who demonstrate minor ABO-incompatibilities with their recipients; and, when needed, transfusion of group O RBCs to recipients of livers from donors with minor ABO-incompatibility who have antibody scores > 60. Immunobematology 1991;2:37–39.