We found a case of Ael for the first time in Korea. The patient was 28-year-old woman admitted for the delivery of her first baby. Patient's red cells were typed as O, while the serum typing was A. The red cells were agglutinated by anti-H, but not agglutinated by anti-A1 or anti-AB. Adsorption of anti-A by patient's RBC was confirmed on the adsorption-elution test. In the saliva, only H substance was demonstable. A substance was not demonstrated either in the serum or in the saliva. A transferase was not demonstrated in patient's serum. One of the patient's sister and her daughter, and the patient's son also had same Ael phenotype.
Adsorption ; Adult ; Female ; Humans ; Korea* ; Nuclear Family ; Phenotype ; Saliva ; Siblings ; Transferases

A 50-year-old male, renal transplant recipient, was admitted with fever and chest discomfort. At admission, chest radiologic finding was negative and echocardiography showed minimal pericardial effusion. After 2 days of admission, chest pain worsened and blood pressure fell to 60/40 mmHg. Emergency echocardiography showed a large amount of pericardial effusion compressing the entire heart. Pericardiocentesis was performed immediately. Mycobacterium tuberculosis was isolated from pericardial fluid. Tuberculosis pericarditis should be considered as the cause of cardiac tamponade in renal transplant recipients, even with the absence of pericardial effusion in the initial study or suggestive history.
Blood Pressure ; Cardiac Tamponade ; Chest Pain ; Echocardiography ; Emergencies ; Fever ; Heart ; Humans ; Kidney Transplantation ; Male ; Middle Aged ; Mycobacterium tuberculosis ; Pericardial Effusion ; Pericardiocentesis ; Pericarditis ; Thorax ; Transplants ; Tuberculosis

Graft-versus-host disease (GVHD) is a rare complication after kidney transplantation. We describe a 62-year-old female with end-stage renal disease due to hypertension. She received a kidney with 4 mismatched human leukocyte antigen (HLA) out of 6 HLA - A, B, DR from a deceased donor. After the procedure, the patient showed watery diarrhea on postoperative day (POD) 45. An endoscopic biopsy of the colon revealed some apoptotic cells consistent with GVHD. Thrombocytopenia was gradually developed on POD 54. She received steroid pulse therapy, and thrombocytopenia did not progress. However, pneumonia, renal failure, and cardiac failure occurred. She died due to multiple organ failure. We must consider GVHD in renal transplant recipients without homozygous or identical HLA, who had only watery diarrhea without other typical GVHD symptoms such as skin rash and fever, although GVHD is rare in renal transplant recipients.
Biopsy ; Colon ; Diarrhea ; Exanthema ; Female ; Fever ; Graft vs Host Disease ; Heart Failure ; Humans ; Hypertension ; Kidney ; Kidney Failure, Chronic ; Kidney Transplantation ; Leukocytes ; Middle Aged ; Multiple Organ Failure ; Pneumonia ; Renal Insufficiency ; Thrombocytopenia ; Tissue Donors

PURPOSE: The aim of this study was to review the epidemiology, clinical features, diagnosis, and effect of treatments of aspergillosis infections in adult liver transplantation patients. METHODS: We retrospectively studied the cases of aspergillosis among 625 (164 deceased donor liver transplantation (DDLT), 461 living donor liver transplantation (LDLT)) adult liver transplantation recipients (> or =18 yrs old) operated between May 1996 to May 2008. RESULTS: Fourteen cases of aspergillosis infection were detected, which consisted of 9 cases of invasive aspergillosis, 5 cases of aspergilloma in maxillary sinuses which occurred before the transplantation. One patient with invasive aspergillosis, who had received liver transplantation overseas and had post-operation care in our center, was also included. Among the 8 cases (1.28%) of invasive aspergillosis (excluding one case operated overseas), 6 cases (3.7%) were DDLT and 2 cases (0.4%) LDLT (P-value<0.05). Among the 6 patients with early onset of invasive aspergillosis, 5 patients (1.8%) had fluconazole and only 1 patient (0.3%) had itraconazole as prophylactic antifungal agent (P-value<0.05). The three cases with localized lesions in the lung survived after lobectomy, but the disseminated and inoperable cases died. CONCLUSION: The incidence of invasive aspergillosis was lower in LDLT cases and prophylactic itraconazole might be more effective than fluconazole. Paranasal aspergilloma, detected before transplantation had no relation with posttransplant invasive aspergillosis infection. Patients who had localized lesion in the lung, and underwent surgery had better survival than who could not.
Adult ; Antifungal Agents ; Aspergillosis ; Fluconazole ; Humans ; Incidence ; Itraconazole ; Liver ; Liver Transplantation ; Living Donors ; Lung ; Maxillary Sinus ; Retrospective Studies ; Tissue Donors ; Transplants