Transfusion-related acute lung injury associated with interdonor incompatibility for the neutrophil-specific antigen HNA-1a.

Abstract:

BACKGROUND AND OBJECTIVES:A patient transfused with two pooled platelet concentrates became breathless. Bilateral infiltrates were seen on chest X-ray. A diagnosis of transfusion-related acute lung injury (TRALI) was made. The patient received 100% oxygen and recovered after 5 days. MATERIALS AND METHODS:Antibody screening, cross-matching for granulocyte and lymphocyte antibodies and typing for granulocyte antigens was undertaken. RESULTS:The patient typed as HNA-1b/HNA-1b. Granulocyte and lymphocyte antibodies were not detected in the patient's serum or in any of the donor sera by cross-match. In antibody screening against typed panel granulocytes, complement-fixing anti-HNA-1a IgM antibodies were detected in the serum of one female donor. Two of the other donors who contributed to the pooled platelet concentrate containing the HNA-1a IgM antibodies typed as HNA-1a/HNA-1b. CONCLUSION:Anti-HNA-1a IgM antibodies may have formed immune complexes with white cell fragments or soluble FcgammaRIII from HNA-1a+ donors in the pooled platelet concentrate and initiated TRALI.

journal_name

Vox Sang

journal_title

Vox sanguinis

authors

Lucas G,Rogers S,Evans R,Hambley H,Win N

doi

10.1159/000031222

subject

Has Abstract

pub_date

2000-01-01 00:00:00

pages

112-5

issue

2

eissn

0042-9007

issn

1423-0410

pii

31222

journal_volume

79

pub_type

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