[Auto-reactive anti-B antibodies and hemolysis in patients with type B blood after kidney transplantation from an O blood group donor].

The course and the treatment of the patient M.F., who after kidney transplantation, produced autoreactive antierythrocyte antibodies is described. The patient M.F. was B, Rh positive and the kidney donor was 0, Rh positive. On the 12th posttransplantation day severe hemolysis, anemia and bilirubinemia were observed. Beside anti-A, autoreactive anti-B antibodies were discovered in the B group patient and the direct antiglobulin test (DAT) was positive. The patient was treated with several transfusions of 0 blood group washed red cells, immunosuppressive drugs (Cyclosporin, Methylprednisolone) and with daily plasmaphereses. After the 5th plasmapheresis the serum became clear, autoreactive anti-B antibodies could not be detected in the serum, but DAT was still positive. At that time the function of the graft was adequate. Between 22nd and 30th posttransplantation day DAT became negative. Autoreactive, anti-B antibodies were generated by the donor's lymphocytes, that were transferred with the kidney graft and which continued to synthetize anti-A,B antibodies in the patients' circulation.