Evaluation of transfusion reactions in patients following transfusion of blood components containing antibodies to HLA class I - An attempt to prevent TRALI in patients

Transfus Apher Sci. 2024 Aug;63(4):103970. doi: 10.1016/j.transci.2024.103970. Epub 2024 Jul 2.

Abstract

In an attempt to mitigate transfusion-related acute lung injury (TRALI), the Oslo Blood Center screened 1369 thrombapheresis donors for human leucocyte antigen (HLA)-specific antibodies. Anti-HLA antibodies were found in 200 donors who were deferred from donation of plasma-rich products. In a retrospective study, 2562 transfusions of thrombocytes (both apheresis and whole blood-derived) from 150 of these donors were subject to a thorough look back-investigation. Reports of 14 transfusion reactions were identified, none of which were classified as TRALI. Our study supports previous data indicating that the risk of TRALI is low. The value of screening for anti-HLA antibodies and subsequent deferral of donors with high levels of such antibodies remains questionable.

Publication types

  • Review

MeSH terms

  • Adult
  • Blood Component Transfusion / adverse effects
  • Female
  • HLA Antigens / immunology
  • Histocompatibility Antigens Class I / immunology
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Transfusion Reaction / immunology
  • Transfusion Reaction / prevention & control
  • Transfusion-Related Acute Lung Injury* / etiology

Substances

  • HLA Antigens
  • Histocompatibility Antigens Class I