title: Analysis of leucocyte antibodies, cytokines, lysophospholipids and cell microparticles in blood components implicated in post-transfusion reactions with dyspnoea.
abstract: OBJECTIVE
  Post-transfusion reactions with dyspnoea (PTR) are major causes of morbidity and death after blood transfusion. Transfusion-related acute lung injury (TRALI) and transfusion-associated circulatory overload (TACO) are most dangerous, while transfusion-associated dyspnoea (TAD) is a milder respiratory distress. We investigated blood components for immune and non-immune factors implicated in PTR.
  
  
  METHODS
  We analysed 464 blood components (RBCs, PLTs, L-PLTs, FFP) transfused to 271 patients with PTR. Blood components were evaluated for 1/antileucocyte antibodies, 2/cytokines: IL-1β, IL-6, IL-8, TNF-α, sCD40L, 3/lysophosphatidylcholines (LysoPCs), 4/microparticles (MPs) shed from plateletes (PMPs), erythrocytes (EMPs) and leucocytes (LMPs).
  
  
  RESULTS
  Anti-HLA class I/II antibodies or granulocyte-reactive anti-HLA antibodies were detected in 18.2% of blood components (RBC and FFP) transfused to TRALI and in 0.5% of FFP transfused to TAD cases. Cytokines and LysoPCs concentrations in blood components transfused to PTR patients did not exceed those in blood components transfused to patients with no PTR. Only EMPs percentage in RBCs transfused to patients with TRALI was significantly higher (P < 0.05) than in RBCs transfused to patients with no PTR.
  
  
  CONCLUSIONS
  Immune character of PTR was confirmed mainly in 1/5 TRALI cases. Among non-immune factors, only MPs released from stored RBCs are suggested as potential mediators of TRALI. Our results require further observations in a more numerous and better defined group of patients.
authors.affiliation: Department of Immunohematology and Immunology of Transfusion Medicine, Institute of Hematology and Transfusion Medicine, Warsaw, Poland.
authors.forename: K
authors.initials: K
authors.lastname: Maślanka
authors.forename: M
authors.initials: M
authors.lastname: Uhrynowska
authors.forename: P
authors.initials: P
authors.lastname: Łopacz
authors.forename: A
authors.initials: A
authors.lastname: Wróbel
authors.forename: G
authors.initials: G
authors.lastname: Smoleńska-Sym
authors.forename: K
authors.initials: K
authors.lastname: Guz
authors.forename: E
authors.initials: E
authors.lastname: Lachert
authors.forename: A
authors.initials: A
authors.lastname: Ostas
authors.forename: E
authors.initials: E
authors.lastname: Brojer
mesh_terms: D055371:Acute Lung Injury / Q000097:blood / Q000209:etiology; D000328:Adult; D000906:Antibodies / Q000097:blood*; D055252:Cell-Derived Microparticles / Q000378:metabolism*; D004417:Dyspnea / Q000097:blood* / Q000209:etiology; D005260:Female; D006801:Humans; D016209:Interleukin-8 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D017713:Platelet Transfusion / Q000009:adverse effects*; D065227:Transfusion Reaction / Q000097:blood* / Q000209:etiology
chemical_list: D000906:Antibodies; D016209:Interleukin-8
keywords: cytokines; leucocyte antibodies; lysophospholipids; microparticles; pulmonary post-transfusion reactions