title: Screening for HLA antibodies in plateletpheresis donors with a history of transfusion or pregnancy.
abstract: BACKGROUND
  Transfusion-related acute lung injury (TRALI) is known as a life-threatening complication of transfusion. HLA and HNA antibodies have been associated with the immune pathway of TRALI. Since donors with a history of transfusion and/or pregnancy are presumed to have an increased risk of carrying such antibodies, we investigated the association of a history of transfusion or pregnancy with the occurrence of HLA alloimmunization in our donor population.
  
  
  METHODS
  A total of 1018 female plateletpheresis donors and male plateletpheresis donors with a history of transfusion were enrolled in the study. Included donors were systematically screened, using Luminex technology, for anti-HLA Class I and II. The association of donor history with HLA alloimmunization status was analyzed.
  
  
  RESULTS
  The overall alloimmunization rate was 20.2%. In 0.0% of the nulliparous transfused female donors and in 1.3% of the transfused male donors, anti-HLA were detected. Thirty-one percent of the parous women versus 4.2% of the nulliparous women screened positive for anti-HLA. The rate of HLA alloimmunization increased with parity.
  
  
  CONCLUSIONS
  Our data indicate that a history of transfusion is a minor risk factor for immunization against HLA antigens. In contrast, former pregnancies constitute a major risk factor for the development of HLA antibodies. Since HLA alloimmunization rate increases with parity, TRALI risk reduction measures should focus on this particular donor population. Repeated testing of female plateletpheresis donors after each pregnancy is implemented in our blood service.
authors.affiliation: Blood Service, Belgian Red Cross-Flanders, Gent, Belgium.
authors.forename: Dorien
authors.initials: D
authors.lastname: De Clippel
authors.forename: Martine
authors.initials: M
authors.lastname: Baeten
authors.forename: Anneleen
authors.initials: A
authors.lastname: Torfs
authors.forename: Marie-Paule
authors.initials: MP
authors.lastname: Emonds
authors.forename: Hendrik B
authors.initials: HB
authors.lastname: Feys
authors.forename: Veerle
authors.initials: V
authors.lastname: Compernolle
authors.forename: Philippe
authors.initials: P
authors.lastname: Vandekerckhove
mesh_terms: D001782:Blood Donors; D046148:Donor Selection / Q000379:methods*; D005260:Female; D005331:Fetomaternal Transfusion / Q000097:blood* / Q000276:immunology; D006680:HLA Antigens; D006801:Humans; D007518:Isoantibodies / Q000097:blood* / Q000276:immunology; D008297:Male; D017713:Platelet Transfusion; D010983:Plateletpheresis; D011247:Pregnancy
chemical_list: D006680:HLA Antigens; D007518:Isoantibodies