Transfusion related acute lung injury (TRALI) caused by red blood cell transfusion involving residual plasma anti-HLA antibodies: a report on two cases and general considerations.
TRALI is considered a serious hazard among immune complications of blood transfusion and its occurrence is admitted to be globally underestimated. Each type of blood product is likely to cause TRALI. We report here on two consecutive observations of TRALI caused by red blood cell concentrates, in which anti-HLA class I and class II antibodies resulting from post-gravitational allo-immunization were evidenced in donors. HLA class I and II antigenic community between recipients and donors' husbands were found and strong reacting IgG antibodies directed at several of those common antigens were detected in the donors' serum. Both donors had more than 3 pregnancies, raising the issue of blood donor selection or of plasma reduction for cellular products.
Etablissement Français du Sang Auvergne, Loire, France.
Hélène
H
Odent-Malaure
Fabienne
F
Quainon
Pascale
P
Ruyer-Dumontier
Soizick
S
Ducroz
Philippe
P
Verdier
Evelyne
E
Voitellier
Marie-Françoise
MF
Raynal
Patricia
P
Fromont
Jean-Yves
JY
Muller
Danielle
D
Rebibo
Léna
L
Absi
Olivier
O
Garraud
D055371:Acute Lung Injury / Q000097:blood / Q000276:immunology*; D000328:Adult; D000368:Aged; D017707:Erythrocyte Transfusion / Q000009:adverse effects*; D005260:Female; D006680:HLA Antigens / Q000276:immunology*; D006801:Humans; D007518:Isoantibodies / Q000009:adverse effects / Q000096:biosynthesis / Q000097:blood*; D008297:Male
D006680:HLA Antigens; D007518:Isoantibodies