Implementation and outcomes of a transfusion-related acute lung injury surveillance programme and study of HLA/HNA alloimmunisation in blood donors.

摘要: Background. Transfusion-related acute lung injury (TRALI) is the leading cause of transfusion-associated mortality. Antibodies against human leucocyte antigens (HLA) and neutrophil (HNA) are often detected in implicated donors. We investigated incidence aetiology TRALI Lombardy. Moreover, we determined rate HLA HNA alloimmunisation genotype a cohort local blood Materials methods. During 2-year observational study eight transfusion services, suspected cases were collected characterised by means antibody screening donors, donor/recipient cross-matching HLA/HNA molecular typing. In addition, 406 Italian donors evaluated for 102 them gene frequencies determined. Results. Eleven referred to central laboratory, whom three diagnosed as having TRALI, seven possible one circulatory overload. Seven immune-mediated whereas did not find either alloantibodies or positive reaction cross-match. The most frequently component was red cells (in 5 males 1 female), four associated with fresh-frozen plasma 3 females male). frequency reported TRALI/possible 1:82,000 1:22,500 plasma. No observed platelets. Overall, 29% 7% males. latter could be related, at least part, natural antibodies. showed that HNA-1b more frequent than HNA-1a our sample Discussion. recently adopted national policy prevent i.e. using only donated males, would have had impact setting.