Are we underestimating reverse TRALI?

Abstract

A 30-year-old woman diagnosed with aplastic anemia following parvovirus B19 infection was hospitalized from March 15 to March 29, 2016. The patient had had a successful kidney transplant in the past. The pretransfusion hemoglobin (Hb) was ABBREVIATIONS: HLA = human leukocyte antigen; HNA = human neutrophil antigen; MFI = mean fluorescence intensity; TRALI = transfusion-related acute lung injury.From the

The Development of Transfusion-Related Acute Lung Injury for the Second Time: A New Awareness for Daratumumab?

“…However, it is assumed that fewer than 10% of TRALI cases are triggered by anti-HLA or anti-HNA antibodies in the patient's plasma (reverse TRALI). 12 Other host-related factors might contribute to the susceptibility to develop a second TRALI reaction for our patient; such as advanced age, having a hematological malignancy, cardiovascular disease, and kidney failure, which can increase host pulmonary neutrophil sensitivity to recipient's 2 Plasmatology HLA, HNA, or nonantibody substances . 2 The role of the complement in TRALI has been investigated in models of antibody-mediated TRALI and daratumumab-induced complement activation may also have a role in the pathogenesis.…”

A possible case of recipient anti‐neutrophil and anti‐human leukocyte antigen antibody‐mediated fatal reverse transfusion‐related acute lung injury

“…While donor‐derived leukoagglutinating antibodies are hypothesized to play a central role in the pathogenesis of TRALI, a few cases of TRALI mediated by recipient‐derived antibodies have been reported. Recipient‐mediated TRALI has been attributed to recipient granulocyte agglutinating anti‐HLA‐A2 in one case and HLA antibodies directed against donor white blood cells in two cases 10–12 . Three cases of red blood cell‐associated TRALI mediated by recipient HLA class I and class II antibodies directed against donor HLA antigens were reported in one case series and a single case of TRALI mediated by anti‐HLA class II antibodies targeting donor antigens in a red blood cell transfusion have been described 11,13 .…”

“…Recipient-mediated TRALI has been attributed to recipient granulocyte agglutinating anti-HLA-A2 in one case and HLA antibodies directed against donor white blood cells in two cases. [10][11][12] Three cases of red blood cell-associated TRALI mediated by recipient HLA class I and class II antibodies directed against donor HLA antigens were reported in one case series and a single case of TRALI mediated by anti-HLA class II antibodies targeting donor antigens in a red blood cell transfusion have been described. 11,13 These case reports and small case series suggest recipient-mediated TRALI is a phenomenon that is likely underreported in part because of the extensive investigation of both donor and recipient HLA and HNA antigens and antibodies is required.…”

Transfusion‐Related acute lung injury (TRALI) caused by antibodies to HLA‐DRB1* 07:01 and HLA‐DQB1*02:02: A case report

“…5,19 Currently, however, there are increasing reports of HLA-II antibodies and their association with severe cases. [19][20][21][22] We collected case reports on TRALI cases caused by HLA-II only from the PubMed and CNKI databases between January 2001 and June 2023. HLA-II antibodies were exclusively identified in 25 cases (Table S1).…”