The impact of screening a platelet donor panel for human leucocyte antigen antibodies to reduce the risk of transfusion‐related acute lung injury

Transfusion‐related acute lung injury reports in the Netherlands: an observational study

“…Reported incidences of WBC‐reactive antibodies in TRALI cases (in donor and/or patient) ranged from 25% to 89% 5,6,13,19 . The prevalence of HLA antibodies in the donor population is 2.3% for males and 17% for females 20,21 . Using these prevalences, we calculated a 37% a priori chance of a random patient in our series to receive at least one blood product from a donor with HLA antibodies, assuming that the patient received blood from 5.3 donors with an equal male‐to‐female ratio to that found in the TRALI cases.…”

Alloexposed blood donors and transfusion‐related acute lung injury: a case‐referent study

“…Since the publication of the first large case series, 3 it has been suggested that TRALI can be caused by antibodies directed against either human neutrophil antigens or human leukocyte antigens of both Class I and Class II 3,9‐13 . These white blood cell (WBC) antibodies arise from exposure of the immune system to allogeneic cells and tissues (alloexposure) 14,15 . This alloexposure can occur through pregnancy, transfusion of blood or blood components, and transplantation of stem cells, tissues, or organs.…”

A solution to the problem of studying blood donor–related risk factors when patients have received multiple transfusions

“…1,8,9 WBC antibodies are almost exclusively found in donors who have previously been exposed to alloantigens and the large majority of alloexposed donors are women who have been pregnant. 10,11 Therefore, donor sex is considered an important donor-related risk factor for TRALI and several countries have excluded female donors from donation of plasma for transfusion. Since it is so important and can be determined so easily, donor sex will be used as an example throughout this article.…”