Reducing the incidence of TRALI in the UK: the results of screening for donor leucocyte antibodies and the development of national guidelines
Version of Record online: 8 DEC 2011
© 2011 The Author(s). Vox Sanguinis © 2011 International Society of Blood Transfusion
Volume 103, Issue 1, pages 10–17, July 2012
How to Cite
Lucas, G., Win, N., Calvert, A., Green, A., Griffin, E., Bendukidze, N., Hopkins, M., Browne, T., Poles, A., Chapman, C. and Massey, E. (2012), Reducing the incidence of TRALI in the UK: the results of screening for donor leucocyte antibodies and the development of national guidelines. Vox Sanguinis, 103: 10–17. doi: 10.1111/j.1423-0410.2011.01570.x
- Issue online: 12 JUN 2012
- Version of Record online: 8 DEC 2011
- Received: 15 September 2011, revised 31 October 2011, accepted 31 October 2011
- blood donors;
- leucocyte antibodies;
- UK guidelines
Background and Objectives Transfusion-related acute lung injury (TRALI) is associated with the passive transfusion of leucocyte antibodies in blood products. Blood Transfusion Services have adopted a number of different strategies for reducing the incidence of TRALI, but, while these have been successful, TRALI has not been completely eliminated. Many Transfusion Services have introduced leucocyte antibody screening of donors to further reduce TRALI. This report describes the results of donor leucocyte antibody screening within NHS Blood and Transplant and the guidelines that have been developed for Transfusion Services within the United Kingdom (UK) to reduce the incidence of TRALI.
Materials and Methods Blood samples from newly recruited female apheresis donors were tested for human leucocyte antigens (HLA) class I and class II antibodies and granulocyte-specific antibodies.
Results A total of 1157 female donors were evaluated. Three hundred and fifteen (27·23%) donors had HLA class I or II antibodies and were returned to red cell component donation. Fifty-seven (6·77%) of the remaining 842 donors were found to have granulocyte-specific antibodies of which 11 (1·31%) had HNA-specific antibodies. A total of 818 donors (70·70%) were accepted for platelet apheresis, 336 donors (29·04%) were returned to red cell component donation, and three donors with HNA-3a antibodies (0·26%) were deferred from therapeutic donation.
Conclusions 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.