Transfusion‐related acute lung injury and leucocyte‐reacting antibodies

Zupańska, B; Uhrynowska, Małgorzata; Michur, H.; Maślanka, Krystyna; Zajko, M.

doi:10.1111/j.1423-0410.2007.00920.x

Cited by 24 publications

(28 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[1][2][3][4] Despite the implementation of TRALI mitigation strategies for plasma and platelet concentrates (PCs), which employ either male-only and/or "antibody-negative" donors, there are still significant numbers of TRALI-related deaths, especially linked to the transfusion of red blood cell (RBC) units. 1,2,4,5 TRALI has been reported to be the result of at least 2 events: the first pertaining to the clinical condition of the patient, and the second to the infusion of antibodies that recognize human lymphocyte antigen (HLA) class I, class II, or granulocyte antigens or the infusion of biological response modifiers, which include both biologically active lipids and soluble CD40 ligand (sCD40L). [6][7][8][9][10][11][12][13][14][15] Standard prestorage leukoreduction (LR) was reported to have decreased TRALI reactions at 1 medical center; however, LR has not affected TRALI incidence in the United States or worldwide.…”

Section: Introductionmentioning

confidence: 99%

Experimental prestorage filtration removes antibodies and decreases lipids in RBC supernatants mitigating TRALI in vivo

Silliman

Kelher

Khan³

et al. 2014

Blood

View full text Add to dashboard Cite

Key Points• TRALI may be induced by antibodies to HLA or HNA antigens or lipids, which accumulate during storage.• Prestorage experimental filtration of RBCs removes HLA and HNA antibodies, decreases lipid priming activity, and mitigates TRALI in an animal model.Transfusion-related acute lung injury (TRALI) remains a significant cause of transfusionrelated 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 antibodymediated 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. (Blood. 2014;123(22):3488-3495)

show abstract

Section: Introductionmentioning

confidence: 99%

Experimental prestorage filtration removes antibodies and decreases lipids in RBC supernatants mitigating TRALI in vivo

Silliman

Kelher

Khan³

et al. 2014

Blood

View full text Add to dashboard Cite

show abstract

“…Although fairly typical, leukopenia associated with leukocyte sequestration in the pulmonary circulation is usually temporary and often passes unnoticed [8]. Recent reports emphasize the diagnostic signifi cance of brain natriuretic peptide (BNP) and it is recommended to determine the BNP concentration in each and every case of post-transfusion respiratory failure [27,31].…”

Section: Clinical Presentationmentioning

confidence: 99%

“…Different countries follow different recommendations. One of the commonly accepted methods is deferral from donation of people immunized by leukocyte antigens during previous transfusions or pregnancy [4,27,32]. Various sources estimate the probability of immunization during transfusion at about 1-12% [5].…”

Section: Preventionmentioning

confidence: 99%

“…It should be emphasized that antibody detection is not indispensable for TRALI diagnosis which is primarily based on the clinical picture [3,27,33]. The diagnostic algorithm is presented in Figure 1.…”

Section: Diagnosismentioning

confidence: 99%

“…Silliman's observations are confi rmed by Covin et al [26] who described an onset of TRALI in a patient after an autologous transfusion where no antibodies were detected in blood but leukocyte activation was induced by accumulation of active lipids. However, recent clinical observations and ex vivo studies question the involvement of biologically active lipids and sCD40L in TRALI development [27][28][29].…”

Section: Etiology and Pathophysiologymentioning

confidence: 99%

See 2 more Smart Citations

Transfusion-related acute lung injury: A dangerous and underdiagnosed noncardiogenic pulmonary edema

Jaworski¹,

Maślanka

Kosior³

2013

Cardiol J

View full text Add to dashboard Cite

Transfusion-related acute lung injury (TRALI) is one of the leading causes of death associated with transfusion of blood and blood components. The understanding of the etiology and pathophysiology of this syndrome has much improved during the last decades, nevertheless numerous issues are still unresolved and symptomatic treatment remains the cornerstone of medical management. Consequently more attention is directed at primary as well as secondary prevention. The awareness of the problem within the medical society is still unsatisfactory which results in a high number of unrecognized cases or of inaccurate diagnoses one of which is cardiogenic pulmonary edema. The aim of this review is to make the TRALI syndrome morefamiliar to clinicians and to emphasize how signifi cant proper medical management is both for the patients presenting TRALI symptoms as well as for future recipients of blood components. (Cardiol J 2013; 20, 4: 337-344)

show abstract

Transfusion‐related acute lung injury: A thrombotic thrombocytopenic purpura treatment‐associated case report and concise review

Cruz¹,

Skipworth

Blue

et al. 2008

J of Clinical Apheresis

View full text Add to dashboard Cite

Blood products are frequently required immediately prior to, during, or just after an apheresis procedure. Transfusion-related acute lung injury (TRALI) is now the leading cause of transfusion-related mortality, surpassing ABO-incompatible hemolytic reactions. The reported incidence of TRALI varies but is estimated at 1 in 5,000 transfusions. The true incidence could be higher because of under-reporting and under-diagnosis. Plasma is the most frequently implicated blood product. While the pathogenesis of TRALI appears multifactorial, one contributing factor seems to be donor antibodies to cognate recipient neutrophil antigens. Biologically active neutrophil-priming substances may also play a role. New diagnostic criteria have recently been proposed to aid in the diagnosis of TRALI. We report a thrombotic thrombocytopenic purpura (TTP) treatment-associated case of TRALI and review the history, pathogenesis, diagnosis and management of this syndrome. Current risk reduction strategies are also discussed.

show abstract

Transfusion‐related acute lung injury and leucocyte‐reacting antibodies

Cited by 24 publications

References 42 publications

Experimental prestorage filtration removes antibodies and decreases lipids in RBC supernatants mitigating TRALI in vivo

Experimental prestorage filtration removes antibodies and decreases lipids in RBC supernatants mitigating TRALI in vivo

Transfusion-related acute lung injury: A dangerous and underdiagnosed noncardiogenic pulmonary edema

Transfusion‐related acute lung injury: A thrombotic thrombocytopenic purpura treatment‐associated case report and concise review

Contact Info

Product

Resources

About