Patient-specific transfusion-related acute lung injury.
Transfusion-related acute lung injury (TRALI) is one of the leading causes of transfusion-associated mortality. The inadvertent transfusion of neutrophil antibodies can cause pulmonary transfusion reactions and TRALI. However, not all patients transfused with neutrophil antibodies experience transfusion reactions. A 22-year-old man with severe aplastic anaemia (SAA) experienced TRALI after a platelet transfusion. The donor was found to be alloimmunized to human neutrophil antigen (HNA)-3a, an antigen expressed by neutrophils from approximately 90% of Caucasians. Eleven other platelet components from this donor were transfused prior to this event and two caused reactions: one chills and one TRALI. Both episodes of TRALI occurred in the same male patient with SAA. The fact that one patient experienced TRALI following both exposures to anti-HNA-3a from the same donor whereas nine other recipients did not adds evidence to the observation that patient factors make a significant contribution to neutrophil antibody-mediated transfusion reactions.
Muniz
M
M
Department of Transfusion Medicine Clinical Center, National Institutes of Health, Bethesda, MD 20892-1184, USA.
Sheldon
S
S
Schuller
R M
RM
Young
N S
NS
Klein
H G
HG
Leitman
S F
SF
Stroncek
D F
DF
D000208:Acute Disease; D000328:Adult; D000741:Anemia, Aplastic / Q000276:immunology / Q000628:therapy; D001782:Blood Donors; D005260:Female; D006801:Humans; D007519:Isoantigens / Q000097:blood; D055370:Lung Injury; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000276:immunology; D017713:Platelet Transfusion / Q000009:adverse effects*
C518134:HNA-3a antigen, human; D007519:Isoantigens