White blood cell-reactive antibodies are undetectable in solvent/detergent plasma.
BACKGROUND
Transfusion-related acute lung injury (TRALI) is a life-threatening complication of transfusion. Although all types of blood products have been associated with TRALI, fresh-frozen plasma (FFP) is the most commonly implicated component. It has been postulated that TRALI is an immune-mediated event, because white blood cell (WBC)-reactive antibodies in the donor's plasma are frequently associated with the syndrome. In contrast to single donor-derived FFP, solvent/detergent (S/D) plasma is produced from multiple donations, leading to an at least 500-fold dilution of a single plasma unit. It was hypothesized that WBC-reactive antibodies are undetectable in S/D FFP.


METHODS
Twenty batches of S/D FFP (5 of each ABH group) were analyzed with well-established routine techniques to detect WBC antibodies.


RESULTS
All samples tested negative for granulocyte-specific as well as HLA Class I and Class II antibodies.


CONCLUSIONS
Different strategies to reduce the risk of TRALI are currently discussed. These include screening of all potentially immunized donors for WBC-reactive antibodies and exclusion of multiparous or all women from donating FFP. Here, it is demonstrated that neither granulocyte- nor lymphocyte-reactive antibodies are detectable in S/D FFP. Thus, S/D FFP may represent a potential alternative to reduce the risk of TRALI associated with the transfusion of FFP.
Sachs
Ulrich J H
UJ
Institute for Clinical Immunology and Transfusion Medicine, Justus-Liebig-University, Giessen, Germany. ulrich.sachs@med.uni-giessen.de
Kauschat
Dörte
D
Bein
Gregor
G
D000328:Adult; D000911:Antibodies, Monoclonal / Q000276:immunology; D003902:Detergents / Q000494:pharmacology*; D006098:Granulocytes / Q000276:immunology; D006680:HLA Antigens / Q000276:immunology; D006801:Humans; D007518:Isoantibodies / Q000097:blood / Q000187:drug effects*; D007962:Leukocytes / Q000276:immunology*; D008214:Lymphocytes / Q000276:immunology; D010949:Plasma / Q000187:drug effects / Q000276:immunology*; D012128:Respiratory Distress Syndrome / Q000209:etiology / Q000276:immunology / Q000517:prevention & control*; D012997:Solvents / Q000494:pharmacology*; D065227:Transfusion Reaction
D000911:Antibodies, Monoclonal; D003902:Detergents; D006680:HLA Antigens; D007518:Isoantibodies; D012997:Solvents