Anti-leucocyte antibodies in platelet apheresis donors with and without prior immunizing events: implications for TRALI prevention

作者：Sigle J P^*; Thierbach J; Infanti L; Muriset M; Hunziker G; Chassot K; Niederhauser C; Gowland P; Holbro A; Sunic K; Buser A; Fontana S

来源：Vox Sanguinis, 2013, 105(3): 244-252.

DOI：10.1111/vox.12045

• apheresis platelets
• donors
• transfusion-related acute lung injury

Background and Objectives
Transfusion-related acute lung injury (TRALI) prevention strategies in platelet (PLT) apheresis donors focus on identifying antileucocyte antibody-positive donors. The use of microbead based assays for screening purposes is hampered by the lack of a consensus cut-off for TRALI prevention and the undefined role of anti-leucocyte antibodies in never-alloexposed donors. This study evaluated anti-leucocyte antibody assays in PLT apheresis donors with and without prior immunizing events with special focus on microbead assay cut-offs, antibody specificities and their potential significance in never-alloexposed donors.
Material and Methods
Blood samples of male and female PLT apheresis donors with and without history of prior immunization were tested for anti-leucocyte antibodies.
Results
Of 262 female and 118 male PLT apheresis donors, 37 center dot 4% had prior immunizing events. Fifty-eight of 238 (24 center dot 4%) donors without prior immunizing event had anti-HLA antibodies confirmed in microbead single antigen assay (mean fluorescence intensity (MFI) >500). Even with a cut-off MFI >3000, anti-HLA antibodies were detected in 10 center dot 6% of female and 4 center dot 3% of male donors without history of immunization. Of the antibody specificities found, 6 of 17 (35 center dot 3%) anti-HLA-A, 4 of 8 (50 center dot 0%) anti-HLA-B and 4 of 6 (66 center dot 6%) anti-HLA class II antibodies have been detected in donors associated with TRALI cases in the literature.
Conclusion
Platelet apheresis donors without history of immunization have anti-leucocyte antibodies that potentially can cause TRALI. In our opinion, this cohort should be included in screening strategies for TRALI prevention. As references and consensus cut-offs have not yet been established, it is premature to use microbead assays as standard for donor screening.

• 出版日期2013-10