title: HLA class II antibodies in transfusion-related acute lung injury.
abstract: 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.
authors.affiliation: Sacramento Medical Foundation Blood Centers, Sacramento, California, USA. patricia.kopko@smfbc.org
authors.forename: P M
authors.initials: PM
authors.lastname: Kopko
authors.forename: M A
authors.initials: MA
authors.lastname: Popovsky
authors.forename: M R
authors.initials: MR
authors.lastname: MacKenzie
authors.forename: T G
authors.initials: TG
authors.lastname: Paglieroni
authors.forename: K N
authors.initials: KN
authors.lastname: Muto
authors.forename: P V
authors.initials: PV
authors.lastname: Holland
mesh_terms: 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
chemical_list: D015395:Histocompatibility Antigens Class I; D000949:Histocompatibility Antigens Class II; D007519:Isoantigens