{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T17:28:19Z","timestamp":1769707699397,"version":"3.49.0"},"reference-count":16,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T00:00:00Z","timestamp":1769126400000},"content-version":"vor","delay-in-days":22,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Passenger lymphocyte syndrome (PLS) is a rare complication following solid organ transplantation (SOT) that has not been reported in pediatric lung transplantation. It consists of hemolysis by antibodies from donor B\u2010lymphocytes against recipient red blood cells (RBCs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We report the case of a 12\u2010year\u2010old girl who received bilateral lung transplantation for bronchiolitis obliterans secondary to graft\u2010versus\u2010host disease. She had undergone allogeneic matched unrelated hematopoietic stem cell transplantation (HSCT) 6\u2009years prior for myelodysplastic syndrome (MDS). Details around the PLS event are reported, with emphasis on novel considerations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Lung transplant was uneventful with minor ABO mismatch between donor (O+) and recipient (A+), with a negative crossmatch. There was an abrupt drop in hemoglobin from 10.8\u2009g\/dL on post\u2010operative day 11 to 6.6\u2009g\/dL on day 13. Direct antiglobulin test and markers for hemolysis were positive. Eluate test returned positive for anti\u2010A1 antibody, confirming PLS. Transfusion with donor\u2010type (O+) RBCs and IVIG were beneficial. A chimerism study revealed no recurrent MDS with fluorescence in\u00a0situ hybridization revealing no circulating lung donor lymphocytes. The process was self\u2010limiting and hemoglobin recovered.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This case is the first to highlight PLS following lung transplantation in a child, and informs around post\u2010HSCT considerations. The novel use of chimerism studies and FISH can help elucidate the PLS course. It remains unclear if HSCT predisposes to PLS after subsequent SOT, although this may be due to sensitization to past RBC antigens.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/petr.70256","type":"journal-article","created":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T06:04:52Z","timestamp":1769234692000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Passenger Lymphocyte Syndrome in Pediatric Lung Transplantation: A Recipient With Previous Hematopoietic Stem Cell Transplantation"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7108-3785","authenticated-orcid":false,"given":"Nicholas","family":"Avdimiretz","sequence":"first","affiliation":[{"name":"Division of Pediatric Respiratory Medicine, British Columbia Children's Hospital University of British Columbia  Vancouver British Columbia Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yigal","family":"Dror","sequence":"additional","affiliation":[{"name":"Division of Pediatric Hematology\/Oncology, The Hospital for Sick Children University of Toronto  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melinda","family":"Solomon","sequence":"additional","affiliation":[{"name":"Division of Pediatric Respirology, Pediatric Lung Transplantation, The Hospital for Sick Children University of Toronto  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,1,23]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1155\/2008\/715769"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.12219"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202306-1107OC"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1537-2995.1991.31191096190.x"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tmrv.2008.12.003"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0000000000002337"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.14634"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhlto.2025.100323"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2025.08.005"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2025.08.004"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2021006279"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2013.03.018"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2013.04.004"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2014.04.008"},{"issue":"3","key":"e_1_2_10_16_1","first-page":"423","article-title":"Passenger Lymphocyte Syndrome in Liver Transplant Recipients: A Description of 12 Cases","volume":"13","author":"Romero S.","year":"2015","journal-title":"Blood Transfusion"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-0012.2004.00158.x"}],"container-title":["Pediatric Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/petr.70256","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/petr.70256","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/petr.70256","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T06:30:46Z","timestamp":1769668246000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/petr.70256"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":16,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1111\/petr.70256"],"URL":"https:\/\/doi.org\/10.1111\/petr.70256","archive":["Portico"],"relation":{},"ISSN":["1397-3142","1399-3046"],"issn-type":[{"value":"1397-3142","type":"print"},{"value":"1399-3046","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2025-11-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-11","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70256"}}