Do HLA antibodies cause hemolytic transfusion reactions or decreased RBC survival?

A retrospective analysis of the value of monocyte monolayer assay results for predicting the clinical significance of blood group alloantibodies

“…The results with anti‐Jr a were surprising because only 5 of 14 (36%) antibodies gave a positive MMA; the literature would suggest that this antibody is usually associated with severe transfusion reactions, but perhaps these are the only case reports that get published. Our result with the one example of anti‐Bg a (indirect antiglobulin test [IAT]= 2 + and MMA = 61% reactivity vs. a pool of commercial Bg[a+] RBCs) is of special interest because Bg antibodies are antibodies to HLA, and recent publications drew attention to the possibility that HLA antibodies may be capable of causing HTRs 33 …”

Immunologic hemolytic anemia associated with neonatal alloimmune thrombocytopenia caused by HLA antibody in a male neonate

“…anti-HLA-B7 antibodies have been reported. [2][3][4][5][6] In our case, although we did not check Bg a antigen before transfusing RBCs, we believe that it did not contain the antigen, as the crossmatch test was compatible.…”

Delayed and acute hemolytic transfusion reactions resulting from red cell antibodies and red cell–reactive HLA antibodies

“…The amount of Bg antigens on RBCs varies between individuals and among RBCs even in an individual 16 . In addition, the antigens may decrease by preservation 17 . The RBCs transfused in the case were relatively fresh (all 5‐8 days of age) and this may have contributed to the hemolysis.…”