HLA class II antibodies in transfusion-related acute lung injury.
BACKGROUND
Transfusion-related acute lung injury (TRALI) is a serious, sometimes fatal, complication of transfusion. Granulocyte and HLA class I antibodies present in blood donors have been associated with TRALI. HLA class II antibodies have recently been described in a few cases of TRALI.


METHODS
Donors involved in TRALI reactions reported to a blood center over an 18-month period were tested for HLA class I and II antibodies as well as granulocyte antibodies, if HLA antibodies were not identified.


RESULTS
HLA class II antibodies were identified, in at least one donor, in 7 (64%) of 11 cases of TRALI. HLA class I antibodies were identified in combination with HLA class II antibodies in 5 of these 7 cases. HLA class I antibodies were exclusively identified in 2 cases. Granulocyte antibodies were identified in 1 case, and no antibodies were identified in another.


CONCLUSIONS
In addition to HLA class I antibodies, HLA class II antibodies are associated with TRALI. Testing of donors for HLA class II antibodies as well as HLA class I and granulocyte antibodies is recommended as part of the investigation of suspected cases of TRALI.
Kopko
P M
PM
Sacramento Medical Foundation Blood Centers, Sacramento, California, USA. patricia.kopko@smfbc.org
Popovsky
M A
MA
MacKenzie
M R
MR
Paglieroni
T G
TG
Muto
K N
KN
Holland
P V
PV
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D001782:Blood Donors; D005260:Female; D006098:Granulocytes / Q000276:immunology; D015395:Histocompatibility Antigens Class I / Q000276:immunology; D000949:Histocompatibility Antigens Class II / Q000276:immunology*; D006801:Humans; D007519:Isoantigens / Q000009:adverse effects* / Q000097:blood / Q000276:immunology; D008297:Male; D008875:Middle Aged; D012128:Respiratory Distress Syndrome / Q000175:diagnosis / Q000209:etiology* / Q000276:immunology*; D065227:Transfusion Reaction
D015395:Histocompatibility Antigens Class I; D000949:Histocompatibility Antigens Class II; D007519:Isoantigens