Plasma from stored packed red blood cells and MHC class I antibodies causes acute lung injury in a 2-event in vivo rat model.
Transfusion-related acute lung injury (TRALI) is the leading cause of transfusion death. We hypothesize that TRALI requires 2 events: (1) the clinical condition of the patient and (2) the infusion of antibodies against MHC class I antigens or the plasma from stored blood. A 2-event rat model was developed with saline (NS) or endotoxin (LPS) as the first event and the infusion of plasma from packed red blood cells (PRBCs) or antibodies (OX18 and OX27) against MHC class I antigens as the second event. ALI was determined by Evans blue dye leak from the plasma to the bronchoalveolar lavage fluid (BALF), protein and CINC-1 concentrations in the BALF, and the lung histology. NS-treated rats did not evidence ALI with any second events, and LPS did not cause ALI. LPS-treated animals demonstrated ALI in response to plasma from stored PRBCs, both prestorage leukoreduced and unmodified, and to OX18 and OX27, all in a concentration-dependent fashion. ALI was neutrophil (PMN) dependent, and OX18/OX27 localized to the PMN surface in vivo and primed the oxidase of rat PMNs. We conclude that TRALI is the result of 2 events with the second events consisting of the plasma from stored blood and antibodies that prime PMNs.
Kelher
Marguerite R
MR
Bonfils Blood Center, Denver, CO 80230, USA
Masuno
Tomhiko
T
Moore
Ernest E
EE
Damle
Sagar
S
Meng
Xianzhong
X
Song
Yong
Y
Liang
Xiayuan
X
Niedzinski
Jerry
J
Geier
Steven S
SS
Khan
Samina Y
SY
Gamboni-Robertson
Fabia
F
Silliman
Christopher C
CC
D055371:Acute Lung Injury / Q000209:etiology* / Q000276:immunology / Q000473:pathology; D000818:Animals; D000906:Antibodies / Q000009:adverse effects*; D001793:Blood Preservation / Q000009:adverse effects; D001992:Bronchoalveolar Lavage Fluid / Q000276:immunology; D004195:Disease Models, Animal; D017707:Erythrocyte Transfusion / Q000009:adverse effects*; D004912:Erythrocytes / Q000502:physiology*; D015395:Histocompatibility Antigens Class I / Q000276:immunology*; D006801:Humans; D008297:Male; D018375:Neutrophil Activation / Q000276:immunology; D010949:Plasma / Q000276:immunology / Q000502:physiology*; D051381:Rats; D017207:Rats, Sprague-Dawley
D000906:Antibodies; D015395:Histocompatibility Antigens Class I