Document Detail


The effect of previous pregnancy and transfusion on HLA alloimmunization in blood donors: implications for a transfusion-related acute lung injury risk reduction strategy.
MedLine Citation:
PMID:  19453983     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Antibodies to human leukocyte antigens (HLA) in donated blood have been implicated as a cause of transfusion-related acute lung injury (TRALI). A potential measure to reduce the risk of TRALI includes screening plateletpheresis donors for HLA antibodies. The prevalence of HLA antibodies and their relationship to previous transfusion or pregnancy in blood donors was determined.
STUDY DESIGN AND METHODS: A total of 8171 volunteer blood donors were prospectively recruited by six US blood centers from December 2006 to May 2007. Donors provided a detailed history of pregnancy and transfusion and a sample for HLA Class I and II antibody testing by multiantigen bead flow analysis.
RESULTS: A total of 8171 donors were enrolled; 7920 (96.9%) had valid HLA antibody test results and 7841 (99%) of those had complete pregnancy and transfusion information. The prevalence of any HLA antibody was similar in nontransfused (n = 1138) and transfused (n = 895) men, 1.0% versus 1.7% (p = 0.16). HLA antibodies were detected in 17.3% of all female donors (n = 5834) and in 24.4% of those with a history of previous pregnancy (n = 3992). The prevalence of HLA antibodies increased in women with greater numbers of pregnancy: 1.7% (zero), 11.2% (one), 22.5% (two), 27.5% (three), and 32.2% (four or more pregnancies; p < 0.0001).
CONCLUSION: HLA Class I and Class II antibodies are detectable at low prevalence in male donors regardless of transfusion and in female donors without known immunizing events. The prevalence of HLA antibodies increases significantly with more pregnancies. These data will allow blood centers to estimate the impact of HLA antibody testing as a potential TRALI risk reduction measure.
Authors:
Darrell J Triulzi; Steven Kleinman; Ram M Kakaiya; Michael P Busch; Philip J Norris; Whitney R Steele; Simone A Glynn; Christopher D Hillyer; Patricia Carey; Jerome L Gottschall; Edward L Murphy; Jorge A Rios; Paul M Ness; David J Wright; Danielle Carrick; George B Schreiber
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2009-05-18
Journal Detail:
Title:  Transfusion     Volume:  49     ISSN:  1537-2995     ISO Abbreviation:  Transfusion     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-09-08     Completed Date:  2009-09-23     Revised Date:  2013-06-02    
Medline Journal Info:
Nlm Unique ID:  0417360     Medline TA:  Transfusion     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1825-35     Citation Subset:  IM    
Affiliation:
From the Institute for Transfusion Medicine, Pittsburgh, Pennsylvania, USA.
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MeSH Terms
Descriptor/Qualifier:
Acute Lung Injury / etiology*,  immunology,  prevention & control*
Adult
Aged
Antibodies / blood,  immunology*
Blood Donors / statistics & numerical data*
Blood Transfusion / adverse effects*,  statistics & numerical data
Female
HLA Antigens / immunology*
Humans
Male
Middle Aged
Pregnancy
Sex Factors
Young Adult
Grant Support
ID/Acronym/Agency:
N01 HB047168/HB/NHLBI NIH HHS; N01 HB047169/HB/NHLBI NIH HHS; N01 HB047170/HB/NHLBI NIH HHS; N01 HB047171/HB/NHLBI NIH HHS; N01 HB047172/HB/NHLBI NIH HHS; N01 HB047174/HB/NHLBI NIH HHS; N01 HB047175/HB/NHLBI NIH HHS; N01HB47168/HB/NHLBI NIH HHS; N01HB47169/HB/NHLBI NIH HHS; N01HB47170/HB/NHLBI NIH HHS; N01HB47171/HB/NHLBI NIH HHS; N01HB47172/HB/NHLBI NIH HHS; N01HB47174/HB/NHLBI NIH HHS; N01HB47175/HB/NHLBI NIH HHS; N01HB57181/HB/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Antibodies; 0/HLA Antigens
Comments/Corrections
Comment In:
Transfusion. 2009 Sep;49(9):1779-82   [PMID:  19735501 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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