TRALI - new challenges for histocompatibility and immunogenetics in transfusion medicine

被引:12
作者
Flesch, B. K. [1 ,2 ]
Petershofen, E. K. [3 ]
Bux, J. [2 ]
机构
[1] German Red Cross Blood Serv W, HLA Lab, D-55543 Bad Kreuznach, Germany
[2] German Red Cross Blood Serv W, Hagen, Germany
[3] Inst Bremen Oldenburg, German Red Cross Blood Transfus Serv NSTOB, Oldenburg, Germany
来源
TISSUE ANTIGENS | 2011年 / 78卷 / 01期
关键词
blood product transfusion; human leukocyte antigen class I and class II; human neutrophil antigens; leukocyte antibodies; transfusion-related acute lung injury; ACUTE LUNG INJURY; BLOOD-DONORS; HLA ANTIBODIES; NEUTROPHILS; PLASMA; ALLOANTIBODY; PATHOGENESIS; PREVALENCE; ACTIVATION; REDUCTION;
D O I
10.1111/j.1399-0039.2011.01713.x
中图分类号
Q2 [细胞生物学];
学科分类号
071013 [干细胞生物学];
摘要
Antibodies against human leukocyte antigens (HLAs) have long been associated with transfusion-related acute lung injury (TRALI). In contrast to febrile transfusion reactions and refractoriness to platelet transfusions in immunized patients, the causative antibodies in TRALI are present in the transfused blood component, i.e. they are formed by the blood donor and not by the recipient. Consequently, blood components with high plasma volume are particularly associated with TRALI. In addition to antibodies against HLAs, antibodies directed against human neutrophil antigens (HNAs) present in the plasma of predominantly multiparous female blood donors can induce severe TRALI reactions. Especially, antibodies to HLA class II and HNA-3a antigens can induce severe or even fatal ALI in critically ill patients. Over the last decade, the clinical importance of TRALI as major cause for severe transfusionrelated morbidities has led to the establishment of new guidelines aimed at preventing this condition, including routine testing for HLA and -HNA antibodies for plasma donors with a history of allogeneic sensitization. This, in turn, poses new challenges for close collaboration between blood transfusion centers and histocompatibility and immunogenetics laboratories, for sensitive and specific detection of the relevant antibodies.
引用
收藏
页码:1 / 7
页数:7
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