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Antibody‐mediated transfusion‐related acute lung injury; from discovery to prevention
Author(s) -
Peters Anna L.,
Van Stein Danielle,
Vlaar Alexander P. J.
Publication year - 2015
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/bjh.13459
Subject(s) - transfusion related acute lung injury , medicine , immunology , antibody , pathophysiology , pathogenesis , human leukocyte antigen , antigen , respiratory distress , lung , pulmonary edema , anesthesia
Summary Transfusion‐related acute lung injury ( TRALI ), a syndrome of respiratory distress caused by blood transfusion, is the leading cause of transfusion‐related mortality. The majority of TRALI cases have been related to passive infusion of human leucocyte antigen ( HLA ) and human neutrophil antigen ( HNA ) antibodies in donor blood. In vitro , ex vivo and in vivo animal models have provided insight in TRALI pathogenesis. The various classes of antibodies implicated in TRALI appear to have different pathophysiological mechanisms for the induction of TRALI involving endothelial cells, neutrophils, monocytes and, as very recently has been discovered, lymphocytes. The HLA and HNA ‐antibodies are found mainly in blood from multiparous women as they have become sensitized during pregnancy. The incidence of TRALI has decreased rapidly following the introduction of a male‐only strategy for plasma donation. This review focuses on pre‐clinical and clinical studies investigating the pathophysiology of antibody‐mediated TRALI .