LIVER-TRANSPLANTATION AFTER POSTTRANSFUSION PURPURA

This report describes a case of liver transplantation performed in an HPA-1a-negative woman who had just suffered from post-transfusion purp ura (PTP) due to anti-HPA-1a (anti-Zw(a)). Although the patient receiv ed multiple transfusions of blood products from random donors and the liver donor was found to be HPA-1a-positive, there was no recurrence o f PTP. An anti-HPA-la of only subclass IgG1 was demonstrated in the pa tient's serum with the platelet-ELISA technique. This is in accordance with our previous finding, where destruction of autologous platelets in HPA-1 immunized individuals was associated with the presence of ant i-HPA-1 antibodies of the IgG3 subclass. The HPA-1 antigens are also e xpressed on endothelial cells and, recently, anti-HPA-1a has been desc ribed in connection with rejection process to a cadaver kidney. In thi s case, however, the patient showed no sign of rejection of the liver during the first 4 months after transplantation.