Liver transplantation after post‐transfusion purpura

This report describes a case of liver transplantation performed in an HPA‐la‐negative woman who had just suffered from post‐transfusion purpura (PTP) due to anti‐HPA‐la (anti–Zwa). Although the patient received multiple transfusions of blood products from random donors and the liver donor was found to be HPA‐la‐positive, there was no recurrence of PTP. An anti‐HPA‐la of only subclass IgGl was demonstrated in the patient'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 anti‐HPA‐1 antibodies of the IgG3 subclass. The HPA‐1 antigens are also expressed on endothelial cells and, recently, anti‐HPA‐la has been described in connection with rejection process to a cadaver kidney. In this case, however, the patient showed no sign of rejection of the liver during the first 4 months after transplantation.