title: Reducing the incidence of TRALI in the UK: the results of screening for donor leucocyte antibodies and the development of national guidelines.
abstract: OBJECTIVE
  Transfusion-related acute lung injury (TRALI) is associated with the passive transfusion of leucocyte antibodies in blood products. Blood Transfusion Services have adopted a number of different strategies for reducing the incidence of TRALI, but, while these have been successful, TRALI has not been completely eliminated. Many Transfusion Services have introduced leucocyte antibody screening of donors to further reduce TRALI. This report describes the results of donor leucocyte antibody screening within NHS Blood and Transplant and the guidelines that have been developed for Transfusion Services within the United Kingdom (UK) to reduce the incidence of TRALI.
  
  
  METHODS
  Blood samples from newly recruited female apheresis donors were tested for human leucocyte antigens (HLA) class I and class II antibodies and granulocyte-specific antibodies.
  
  
  RESULTS
  A total of 1157 female donors were evaluated. Three hundred and fifteen (27·23%) donors had HLA class I or II antibodies and were returned to red cell component donation. Fifty-seven (6·77%) of the remaining 842 donors were found to have granulocyte-specific antibodies of which 11 (1·31%) had HNA-specific antibodies. A total of 818 donors (70·70%) were accepted for platelet apheresis, 336 donors (29·04%) were returned to red cell component donation, and three donors with HNA-3a antibodies (0·26%) were deferred from therapeutic donation.
  
  
  CONCLUSIONS
  Female donors with leucocyte antibodies were identified in a stratified screening programme. Donors with antibodies were either directed to red cell donation or deferred. This process, combined with other measures that have already been introduced, is anticipated to further reduce the incidence of TRALI.
authors.affiliation: NHSBT-Filton, North Bristol Park, Filton, Bristol, UK. geoff.lucas@nhsbt.nhs.uk
authors.forename: G
authors.initials: G
authors.lastname: Lucas
authors.forename: N
authors.initials: N
authors.lastname: Win
authors.forename: A
authors.initials: A
authors.lastname: Calvert
authors.forename: A
authors.initials: A
authors.lastname: Green
authors.forename: E
authors.initials: E
authors.lastname: Griffin
authors.forename: N
authors.initials: N
authors.lastname: Bendukidze
authors.forename: M
authors.initials: M
authors.lastname: Hopkins
authors.forename: T
authors.initials: T
authors.lastname: Browne
authors.forename: A
authors.initials: A
authors.lastname: Poles
authors.forename: C
authors.initials: C
authors.lastname: Chapman
authors.forename: E
authors.initials: E
authors.lastname: Massey
mesh_terms: D055371:Acute Lung Injury / Q000097:blood / Q000453:epidemiology / Q000276:immunology* / Q000517:prevention & control; D000906:Antibodies / Q000097:blood* / Q000276:immunology; D001781:Blood Component Removal; D001782:Blood Donors; D001803:Blood Transfusion / Q000706:statistics & numerical data; D005260:Female; D057166:High-Throughput Screening Assays / Q000379:methods; D015395:Histocompatibility Antigens Class I / Q000276:immunology; D000949:Histocompatibility Antigens Class II / Q000276:immunology; D006650:Histocompatibility Testing / Q000379:methods; D006801:Humans; D015994:Incidence; D007518:Isoantibodies / Q000097:blood* / Q000276:immunology; D007962:Leukocytes / Q000276:immunology*; D065227:Transfusion Reaction; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D000906:Antibodies; D015395:Histocompatibility Antigens Class I; D000949:Histocompatibility Antigens Class II; D007518:Isoantibodies