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.

Since 2000, Quality Assurance (QA) exercises for the detection and identification of granulocyte antibodies and DNA typing for human neutrophil antigens (HNA) have been distributed within the International Granulocyte Immunobiology Workshops, which are linked to International Society of Blood Transfusion. The exercises were standardised at the outset to enable laboratory performance to be monitored. Between 2000 and 2012, nine exercises were distributed to 20 laboratories. Overall, 45 examples of 42 unique samples containing defined granulocyte reactive antibodies were distributed for serological analysis together with 20 samples for HNA genotyping. The level of satisfactory serological performance was initially set at 50% and later increased to 70%, while the 'cut-off' for HNA genotyping was set at 100% after 2008. Failure to achieve the minimum score in the QA exercises in consecutive years resulted in temporary exclusion. In 2000, the 15 participating laboratories had a mean score of 56.1% for serological analysis and 13 laboratories attempted HNA-1a and -1b genotyping, while 11 attempted HNA-1c typing. Steady improvements in proficiency for serological testing and HNA typing occurred in subsequent exercises. In 2012, the mean score for serology was 88.5% and 12/13 laboratories scored 100% for HNA-1a, -1b, -1c, -3a, -3b, -4a, -4bw, -5a and -5bw genotyping. These QA exercises have provided an invaluable tool to monitor and improve the standard of granulocyte immunology investigations for participating laboratories, thereby enhancing performance for both clinical investigations and donor screening programmes to reduce the incidence of TRALI.

An enzyme-linked immunosorbent assay (ELISA) was developed for detecting antibodies in anaplasmosis with an antigen prepared from infected bovine erythrocytes. Protein A labeled with horseradish peroxidase was used as conjugate. A comparison was made of results of ELISA, complement fixation test (CFT), and card test (CT) on sera from 97 cows in a herd in which anaplasmosis had been diagnosed. Positive ELISA reactions were observed in serum dilutions of 1:20 or greater in each of 26 cows positive by CFT and in 18 of 22 cows suspected by CFT. Of 49 cows negative by CFT, 31 were negative by ELISA. Positive ELISA reactions were observed in 45 cows positive by CT; 27 of 44 cows negative by CT were negative by ELISA. No ELISA reactions were detected in the sera of 23 cows found negative in the CFT and CT or in 8 cows negative in CFT and positive in CT. No positive CFT, CT, or ELISA reactions were observed in sera of cattle in a noninfected herd.

HPA-3a IgM antibodies can inhibit PLT-specific HPA-3a IgG antibodies in the MAIPA assay.

We report a case of severe acute thrombocytopenia occurring within days after a cadaveric liver transplant, received from a female patient with aplastic anemia who died of intracranial bleeding. The donor, who was homozygous for the ITGA2B*002 (HPA-3b) gene, had developed human platelet antigen (HPA)-3a antibodies, whereas the recipient was homozygous for the ITGA2B*001 (HPA-3a) gene. Thrombocytopenia responded to an infusion of immunoglobulin G. This is the first report of a passenger lymphocyte syndrome manifesting with thrombocytopenia due to anti-HPA-3a. We review the literature on thrombocytopenia in the setting of PLS and discuss the differential diagnosis.