Testing only donors with a prior history of pregnancy or transfusion is a logical and cost-effective transfusion-related acute lung injury prevention strategy

Transfusion
Amy PowersRobert S Makar

Abstract

Transfusion-related acute lung injury (TRALI) is the leading cause of transfusion-related fatality reported to the Food and Drug Administration. Donor screening may reduce TRALI risk. This study sought to compare the efficacy and safety of different TRALI risk-reduction strategies at a hospital-based donor center. Samples from 1053 donors who answered questions regarding pregnancy and transfusion history were tested for HLA Class I and II antibodies using a flow cytometry-based screening assay. Donor history was compared with the presence of HLA alloantibodies. These data were used to model several TRALI risk-reduction strategies. The medical records of patients transfused fresh-frozen plasma (FFP) from highly alloimmunized donors were retrospectively reviewed for TRALI. HLA alloimmunization was observed among 25.4 percent (256/1009) of all female donors and among 12.0 percent (3/25) of those male donors who gave a history of prior transfusion. Prior pregnancy, reported by 52.6 percent (531/1009) of females, correlated significantly with HLA alloimmunization (p < 0.0001). The rate of HLA alloimmunization increased with parity. A positive pregnancy history was a sensitive (87.9%) screen for HLA alloimmunization with a negative p...Continue Reading

References

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Citations

May 1, 2013·Human Immunology·Emeline MassonJean-Michel Rebibou
Apr 23, 2009·American Journal of Respiratory and Critical Care Medicine·Robert A FowlerGordon D Rubenfeld
Jun 4, 2014·European Journal of Anaesthesiology·Hanane El Kenz, Philippe Van der Linden
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Oct 28, 2010·Transfusion·Jerome L GottschallUNKNOWN NHLBI Retrovirus Epidemiology Donor Study II
Apr 27, 2012·Journal of Clinical Apheresis·Dennis WilliamsPatricia Carey
Dec 25, 2010·Transfusion·Jorge A RiosUNKNOWN NHLBI Retrovirus Epidemiology Donor Study-II
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Oct 12, 2011·Transfusion·Rutger A MiddelburgJohanna G van der Bom
Nov 20, 2010·Transfusion·Danielle M CarrickUNKNOWN NHLBI Retrovirus Epidemiology Donor Study-II (REDS-II)
Jan 12, 2013·Transfusion·Manish J GandhiUNKNOWN National Heart, Lung, and Blood Institute Specialized Center of Clinically Oriented Research TRALI Study and Retrovirus Epid
May 13, 2014·American Journal of Hematology·Jeremy Ryan A PeñaRobert S Makar
Aug 25, 2009·Blood Reviews·Christopher C SillimanSamina Y Khan
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May 28, 2014·Transfusion·Dorien De ClippelPhilippe Vandekerckhove
Dec 17, 2014·Transfusion·James P AuBuchon
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Nov 11, 2017·Vox Sanguinis·M P JanssenJ C Wiersum-Osselton
Nov 11, 2018·Human Immunology·Mohamed SlimaneJulie Di Cristofaro

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