title: Allo-exposure status and leucocyte antibody positivity of blood donors show a similar relation with TRALI.
abstract: BACKGROUND
  The fraction of transfusion-related acute lung injury (TRALI) cases preventable by deferral of allo-exposed donors has previously been estimated, under the assumption this indirectly estimated the contribution of leucocyte antibodies to the occurrence of TRALI. Our aim was to estimate the fraction preventable by deferral of leucocyte antibody positive donors and to investigate the validity of allo-exposure as a marker for leucocyte antibodies.
  
  
  METHODS
  All donors involved in a series of previously published TRALI patients were tested for leucocyte antibodies. The observed number of antibody positive donors was compared to the expected number. From this comparison we estimated the contribution of leucocyte antibodies to the occurrence of TRALI and compared this to the previously reported estimate for allo-exposed donors.
  
  
  RESULTS
  Sixty-one TRALI patients were included. Of 288 involved donors 43 were expected and 67 were observed to be leucocyte antibody positive. The observed percentage of positive donors was 8.3% (95% confidence interval (CI): 5.1-11.5%) in excess of the expected. Overall 59% (95% CI: 34-85%) of TRALI cases was estimated to be preventable by the exclusion of all leucocyte antibody positive donors. For plasma-poor products this was 16% (95% CI: -5.0 to 36%).
  
  
  CONCLUSIONS
  These estimates were similar to those previously published for allo-exposed donors. This suggests allo-exposure status can effectively be used in donor deferral strategies.
authors.affiliation: Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands. R.Middelburg@Sanquin.nl
authors.forename: R A
authors.initials: RA
authors.lastname: Middelburg
authors.forename: E A M
authors.initials: EA
authors.lastname: Beckers
authors.forename: L
authors.initials: L
authors.lastname: Porcelijn
authors.forename: N
authors.initials: N
authors.lastname: Lardy
authors.forename: J C
authors.initials: JC
authors.lastname: Wiersum-Osselton
authors.forename: M R
authors.initials: MR
authors.lastname: Schipperus
authors.forename: H
authors.initials: H
authors.lastname: Vrielink
authors.forename: E
authors.initials: E
authors.lastname: Briët
authors.forename: J G
authors.initials: JG
authors.lastname: van der Bom
mesh_terms: D055371:Acute Lung Injury / Q000097:blood / Q000209:etiology / Q000276:immunology / Q000517:prevention & control*; D001782:Blood Donors; D046148:Donor Selection / Q000379:methods*; D005260:Female; D006801:Humans; D007518:Isoantibodies / Q000097:blood* / Q000276:immunology*; D007962:Leukocytes / Q000276:immunology*; D008297:Male; D012189:Retrospective Studies; D065227:Transfusion Reaction
chemical_list: D007518:Isoantibodies