Presence of HLA antibodies in single‐donor‐derived fresh frozen plasma compared with pooled, solvent detergent‐treated plasma (Octaplas®)

Abstract

Adverse reactions to plasma transfusion are well documented. One of the most serious hazards of transfusion, transfusion-related acute lung injury (TRALI), has nearly as high an incidence of mortality and major morbidity as that reported for the transfusion of incorrect blood components. The specific mechanisms of plasma component-induced adverse reactions remain unclear, but a major contribution may be related to the presence of alloantibodies. In this study, a laboratory analysis was undertaken to determine the presence of HLA antibodies in leucodepleted single-donor-derived fresh frozen plasma (FFP). A comparison was made with a pooled plasma product that has undergone solvent detergent treatment. In total, 58 plasma samples from single-donor units of leucodepleted FFP were tested along with samples from 12 units (three for each ABO blood group) of the pooled plasma (Octaplas); Octapharma Ltd, Coventry, UK), for the presence of HLA antibodies. HLA-specific enzyme-linked immunosorbent assay (ELISA) methods were used to screen for their presence, and complement-dependent cytotoxicity and flow cytometry analyses were used to further define their presence, specificity and class [immunoglobulin G (IgG)/IgM]. In the study groups, HLA antibodies were found to be present in five of the single-donor units (9%) while the pooled plasma samples tested negative.

Transfusion-related acute lung injury: from bedside to bench and back

“…83,84 Importantly, SD plasma has not been associated with TRALI, although more than 13 million units have been transfused. 85 …”

Trends in the diagnosis and management of TTP: European perspective

“…To reduce the risk of TRALI, the use of male only plasma has been introduced. In a comparison of HLA antibodies in single donor FFP (n = 58) versus Octaplas (n = 12), there were 9% cases with HLA antibodies in standard FFP, but not detected in Octaplas [30]In the 2010 SHOT report, per 100,000 units of plasma, the incidence of febrile reactions was 1.0 for standard plasma and 0.0 for Octaplas. Allergic reactions were documented in 8.7 in standard FFP and 0.17 for Octaplas.…”

Universal Pathogen-Reduced Plasma in Elective Open-Heart Surgery and Liver Resection

“…9 The identical production process should ensure that Uniplas demonstrates the same safety with respect to transfusion-related acute lung injury and febrile, urticarial and anaphylactoid reactions as Octaplas. 34,35,36,37 Cost-effectiveness of pathogen reduction is low in the developed world due to the very low risk of transfusion transmittable infections after introduction of modern methods for the detection of infectious agents. 29 High cost per quality-adjusted life year estimates of US $2-9 million have been published for SD-treated plasma.…”