New onset anaemia within three months after renal transplantation though not very common sometimes present as diagnostic challenge to the renal physicians. Understanding the etiology is necessary for correct management and avoiding adverse graft outcome.
Passenger lymphocyte syndrome (PLS) is a rare entity of immune haemolytic anaemia that sometimes occurs in recipient of minor ABO mismatched renal transplantation. In this case report we present an AB positive renal allograft recipient who received organ from an O positive donor and developed acute haemolytic anaemia and jaundice, 19 days after renal transplantation due to PLS.