title: Experimental prestorage filtration removes antibodies and decreases lipids in RBC supernatants mitigating TRALI in vivo.
abstract: Transfusion-related acute lung injury (TRALI) remains a significant cause of transfusion-related mortality with red cell transfusion. We hypothesize that prestorage filtration may reduce proinflammatory activity in the red blood cell (RBC) supernatant and prevent TRALI. Filters were manufactured for both small volumes and RBC units. Plasma containing antibodies to human lymphocyte antigen (HLA)-A2 or human neutrophil antigen (HNA)-3a was filtered, and immunoglobulins and specific HNA-3a and HLA-2a neutrophil (PMN) priming activity were measured. Antibodies to OX27 were added to plasma, and filtration was evaluated in a 2-event animal model of TRALI. RBC units from 31 donors known to have antibodies against HLA antigens and from 16 antibody-negative controls were filtered. Furthermore, 4 RBC units were drawn and underwent standard leukoreduction. Immunoglobulins, HLA antibodies, PMN priming activity, and the ability to induce TRALI in an animal model were measured. Small-volume filtration of plasma removed >96% of IgG, antibodies to HLA-A2 and HNA-3a, and their respective priming activity, as well as mitigating antibody-mediated in vivo TRALI. In RBC units, experimental filtration removed antibodies to HLA antigens and inhibited the accumulation of lipid priming activity and lipid-mediated TRALI. We conclude that filtration removes proinflammatory activity and the ability to induce TRALI from RBCs and may represent a TRALI mitigation step.
authors.affiliation: The Research Laboratory, Bonfils Blood Center, Denver, CO; Department of Pediatrics and Department of Surgery, School of Medicine, University of Colorado Denver, Aurora, CO;
authors.forename: Christopher C
authors.initials: CC
authors.lastname: Silliman
authors.affiliation: The Research Laboratory, Bonfils Blood Center, Denver, CO; Department of Surgery, School of Medicine, University of Colorado Denver, Aurora, CO;
authors.forename: Marguerite R
authors.initials: MR
authors.lastname: Kelher
authors.affiliation: The Research Laboratory, Bonfils Blood Center, Denver, CO; Department of Pediatrics and.
authors.forename: Samina Y
authors.initials: SY
authors.lastname: Khan
authors.affiliation: Reference Laboratory and.
authors.forename: Monica
authors.initials: M
authors.lastname: LaSarre
authors.affiliation: Medical Affairs, Bonfils Blood Center, Denver, CO;
authors.forename: F Bernadette
authors.initials: FB
authors.lastname: West
authors.affiliation: Texas Region, Blood Systems Inc., Phoenix, AZ;
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Land
authors.affiliation: Pall Corporation, Port Washington, NY; and.
authors.forename: Barbara
authors.initials: B
authors.lastname: Mish
authors.affiliation: Pall Corporation, Port Washington, NY; and.
authors.forename: Linda
authors.initials: L
authors.lastname: Ceriano
authors.affiliation: Haemonetics Corporation, Braintree, MA.
authors.forename: Samuel
authors.initials: S
authors.lastname: Sowemimo-Coker
mesh_terms: D019794:2,3-Diphosphoglycerate / Q000097:blood; D055371:Acute Lung Injury / Q000209:etiology*; D000255:Adenosine Triphosphate / Q000097:blood; D000818:Animals; D000906:Antibodies / Q000276:immunology*; D001781:Blood Component Removal / Q000379:methods*; D016913:Blood Component Transfusion / Q000009:adverse effects*; D001782:Blood Donors; D004912:Erythrocytes / Q000276:immunology*; D005260:Female; D005374:Filtration / Q000379:methods*; D006680:HLA Antigens / Q000276:immunology; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007963:Leukocytes, Mononuclear / Q000276:immunology / Q000378:metabolism; D008055:Lipids / Q000276:immunology*; D008297:Male; D010949:Plasma / Q000276:immunology; D051381:Rats
chemical_list: D000906:Antibodies; D006680:HLA Antigens; D008055:Lipids; D019794:2,3-Diphosphoglycerate; D000255:Adenosine Triphosphate
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