title: Recommendations of the ISBT Working Party on Granulocyte Immunobiology for leucocyte antibody screening in the investigation and prevention of antibody-mediated transfusion-related acute lung injury.
abstract: BACKGROUND
  Transfusion-related acute lung injury (TRALI) is currently one of the most common causes of transfusion-related major morbidity and death. Among the many TRALI mediators, leucocyte antibodies have been identified as important triggers of severe TRALI.
  
  
  METHODS
  These recommendations were compiled by experts of the ISBT Working Party on Granulocyte Immunobiology, based on the results obtained in eight international granulocyte immunology workshops, their personal experiences and on published study results.
  
  
  RESULTS
  Leucocyte antibody screening has to include the detection of human leucocyte antigen (HLA) class I, class II and human neutrophil alloantigen antibodies using established and validated techniques. HLA class I antibody detection should be restricted to antibodies clinically relevant for TRALI. To avoid unnecessary workload, TRALI diagnosis should be assessed by consultation with the reporting clinician and thorough exclusion of transfusion-associated circulatory overload/cardiac insufficiency. In patients diagnosed with TRALI having donors with detectable leucocyte antibodies, evidence of leucocyte incompatibility should be provided by either cross-matching or typing of patient for cognate antigen.
  
  
  CONCLUSIONS
  Leucocyte antibody screening for the immunological clarification of TRALI cases as well as for identification of potentially alloimmunized blood donors is feasible and can be performed in a reasonable and quality assured manner. This practice can contribute to the prevention of antibody-mediated TRALI.
authors.affiliation: Platelet and Leucocyte Immunology Laboratory, EFS Ile de France, Hopital Henri Mondor, Creteil, France.
authors.forename: P
authors.initials: P
authors.lastname: Bierling
authors.forename: J
authors.initials: J
authors.lastname: Bux
authors.forename: B
authors.initials: B
authors.lastname: Curtis
authors.forename: B
authors.initials: B
authors.lastname: Flesch
authors.forename: L
authors.initials: L
authors.lastname: Fung
authors.forename: G
authors.initials: G
authors.lastname: Lucas
authors.forename: M
authors.initials: M
authors.lastname: Macek
authors.forename: E
authors.initials: E
authors.lastname: Muniz-Diaz
authors.forename: L
authors.initials: L
authors.lastname: Porcelijn
authors.forename: A
authors.initials: A
authors.lastname: Reil
authors.forename: U
authors.initials: U
authors.lastname: Sachs
authors.forename: R
authors.initials: R
authors.lastname: Schuller
authors.forename: N
authors.initials: N
authors.lastname: Tsuno
authors.forename: M
authors.initials: M
authors.lastname: Uhrynowska
authors.forename: S
authors.initials: S
authors.lastname: Urbaniak
authors.forename: N
authors.initials: N
authors.lastname: Valentin
authors.forename: A
authors.initials: A
authors.lastname: Wikman
authors.forename: B
authors.initials: B
authors.lastname: Zupanska
mesh_terms: D055371:Acute Lung Injury / Q000097:blood / Q000209:etiology / Q000276:immunology / Q000517:prevention & control*; D001323:Autoantibodies / Q000009:adverse effects / Q000097:blood* / Q000276:immunology; D016913:Blood Component Transfusion; D001782:Blood Donors; D046148:Donor Selection / Q000379:methods*; D005260:Female; D006801:Humans; D007519:Isoantigens / Q000097:blood* / Q000276:immunology; D008297:Male
chemical_list: D001323:Autoantibodies; D007519:Isoantigens