Red cell antibody production due to primary immune response by lymphoid tissue in a grafted liver

Some recipients of solid organ transplants have been reported to develop haemolytic anaemia. Most cases have been blood group A or B organ recipients with blood group O donors. The donor B memory lymphocytes transplanted with the organ have proved to be a source of anti-A and anti-B giving rise to such anaemia. A few cases where anti-D or other red cell antibodies have been found post-transplantation have also been published, but in all cases the antibody has been present in the donor prior to transplantation. We present a case of red cell antibody production due to primary immune response by lymphoid tissue in a grafted liver.