Faculty Collaboration Database

Recommendations of the ISBT Working Party on Granulocyte Immunobiology for leucocyte antibody screening in the investigation and prevention of antibody-mediated transfusion-related acute lung injury. Vox Sang 2009 Apr;96(3):266-9

Date

02/12/2009

Pubmed ID

19207164

DOI

10.1111/j.1423-0410.2008.01144.x

Scopus ID

2-s2.0-62349131370 (requires institutional sign-in at Scopus site)   70 Citations

Abstract

BACKGROUND: Transfusion-related acute lung injury (TRALI) is currently one of the most common causes of transfusion-related major morbidity and death. Among the many TRALI mediators, leucocyte antibodies have been identified as important triggers of severe TRALI.

STUDY DESIGN AND METHODS: These recommendations were compiled by experts of the ISBT Working Party on Granulocyte Immunobiology, based on the results obtained in eight international granulocyte immunology workshops, their personal experiences and on published study results.

RESULTS: Leucocyte antibody screening has to include the detection of human leucocyte antigen (HLA) class I, class II and human neutrophil alloantigen antibodies using established and validated techniques. HLA class I antibody detection should be restricted to antibodies clinically relevant for TRALI. To avoid unnecessary workload, TRALI diagnosis should be assessed by consultation with the reporting clinician and thorough exclusion of transfusion-associated circulatory overload/cardiac insufficiency. In patients diagnosed with TRALI having donors with detectable leucocyte antibodies, evidence of leucocyte incompatibility should be provided by either cross-matching or typing of patient for cognate antigen.

CONCLUSION: Leucocyte antibody screening for the immunological clarification of TRALI cases as well as for identification of potentially alloimmunized blood donors is feasible and can be performed in a reasonable and quality assured manner. This practice can contribute to the prevention of antibody-mediated TRALI.

Author List

ISBT Working Party on Granulocyte Immunobiology, Bierling P, Bux J, Curtis B, Flesch B, Fung L, Lucas G, Macek M, Muniz-Diaz E, Porcelijn L, Reil A, Sachs U, Schuller R, Tsuno N, Uhrynowska M, Urbaniak S, Valentin N, Wikman A, Zupanska B

Author

Brian Curtis PhD Director in the Platelet & Neutrophil Immunology Laboratory department at BloodCenter of Wisconsin

MESH terms used to index this publication - Major topics in bold

Acute Lung Injury
Autoantibodies
Blood Component Transfusion
Blood Donors
Donor Selection
Female
Humans
Isoantigens
Male