Reducing the incidence of TRALI in the UK: the results of screening for donor leucocyte antibodies and the development of national guidelines

Abstract

Female donors with leucocyte antibodies were identified in a stratified screening programme. Donors with antibodies were either directed to red cell donation or deferred. This process, combined with other measures that have already been introduced, is anticipated to further reduce the incidence of TRALI.

Luminex® and Its Applications for Solid Organ Transplantation, Hematopoietic Stem Cell Transplantation, and Transfusion^*

“…In order to reduce the cases of TRALI without generally excluding all females from donating plasma, an antibody pre-screening in the UK identified donors positive for HLAab or HNAab and excludes only those from donating [64,65]. This practice was confirmed by a recent study by the Canadian Blood Services [66].…”

TRALI: reducing its risk while trying to understand its causes

“…However, those immunized solely to HNA antigens, particularly HNA-3a, represent a TRALI risk hidden among approximately 7% of all women. 18 Currently developed tests for HNA antibodies can be useful to investigate a specific case but are not amenable to screening large numbers of donor samples, particularly with a rapid turnaround requirement. The development of such a test platform, which is under way, should be welcomed by blood collectors as a recent poll of ABC centers indicated that a majority would "definitely" or "probably" implement such a test were it available.…”

Pulmonary Complications of Transfused Blood Components

“…In addition, some countries have initiated antibody testing and other production techniques to reduce antibody contamination. 73,74 Fortunately, this blood banking strategy has reduced reported TRALI incidence and mortality in most before-and-after studies. 75–77 …”