[Non-cardiogenic pulmonary edema after transfusion of plasma containing an anti-HLA-B21 antibody].
A patient with a von Willebrand factor deficiency received three units of fresh frozen plasma during a postoperative period. During the last unit transfusion she developed a severe respiratory distress and non cardiac pulmonary edema was diagnosed based upon the clinical, radiological and hemodynamic findings. Reintubation and mechanical ventilation with end-expiratory pressure were instituted leading to a complete and rapid recovery within 48 h. The serum from the last plasma donor contains an anti-HLA-B21 lymphocytotoxic antibody that did agglutinate neutrophils from HLA-B21 positive individuals. The patient's HLA type was B21. The concerned donor was a IVpar Igeste female. Two problems are evoked by this observation with regard to transfusion: first, fresh-frozen plasma was used as an inappropriate treatment for a coagulating factor deficiency, second, exclusion of this donor from a classical blood donation is needed.
Celton
J L
JL
CTS, Hôpital Necker-Enfants malades, Paris.
Bedock
B
B
Pambet
T
T
André
O
O
Cartron
J
J
Carton
J
J
D000328:Adult; D001782:Blood Donors; D001803:Blood Transfusion; D005260:Female; D015235:HLA-B Antigens / Q000276:immunology*; D006801:Humans; D007518:Isoantibodies / Q000009:adverse effects*; D011654:Pulmonary Edema / Q000209:etiology*; D014842:von Willebrand Diseases / Q000628:therapy
D015235:HLA-B Antigens; C063569:HLA-B21 antigen; D007518:Isoantibodies
Oedème pulmonaire non cardiogénique après transfusion de plasma contenant un anticorps anti-HLA-B21.