TRALI after the transfusion of cross-match-positive granulocytes.
BACKGROUND
TRALI is a serious complication of transfusion. WBC antibodies have been associated with TRALI. The importance of such antibodies for the transfusion of granulocytes is unknown.


METHODS
A patient with hematologic malignancy and neutropenia-associated pneumonitis received 2 units of granulocytes despite a positive serologic cross- match. She developed severe TRALI after the second transfusion.


RESULTS
The recipient's serum was reactive with immobilized HLA class I antigens from donor cells in a glycoprotein-specific assay. With an absorption-elution technique, at least anti-HLA-A2 could be identified as one of the donor-reactive antibodies in the recipient's serum.


CONCLUSIONS
Granulocyte-reactive antibodies are associated with TRALI in an alloimmunized patient receiving granulocyte transfusions. Performing a cross-match procedure may be helpful in preventing severe pulmonary reactions. Additional data are required to determine whether cross-matching as a regular practice in granulocyte transfusions would be beneficial for patients.
Sachs
Ulrich J
UJ
Institute for Clinical Immunology and Transfusion Medicine, Justus Liebig-University, Giessen, Germany. ulrich.sachs@immunologie.med.uni-giessen.de
Bux
Jürgen
J
D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects; D016913:Blood Component Transfusion / Q000009:adverse effects*; D001788:Blood Grouping and Crossmatching; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007938:Leukemia / Q000150:complications / Q000188:drug therapy; D009503:Neutropenia / Q000139:chemically induced / Q000276:immunology / Q000628:therapy*; D009504:Neutrophils / Q000276:immunology*; D011014:Pneumonia / Q000209:etiology* / Q000276:immunology*
D000970:Antineoplastic Agents