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TRALI after the transfusion of cross‐match‐positive granulocytes
Author(s) -
Sachs Ulrich J.,
Bux Jürgen
Publication year - 2003
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/j.0041-1132.2003.00568.x
Subject(s) - medicine , granulocyte , antibody , immunology , transfusion related acute lung injury , neutropenia , isoantibodies , human leukocyte antigen , serology , antigen , lung , chemotherapy , pulmonary edema
BACKGROUND: TRALI is a serious complication of transfusion. WBC antibodies have been associated with TRALI. The importance of such antibodies for the transfusion of granulocytes is unknown. CASE REPORT: A patient with hematologic malignancy and neutropenia‐associated pneumonitis received 2 units of granulocytes despite a positive serologic cross‐ match. She developed severe TRALI after the second transfusion. RESULTS: The recipient's serum was reactive with immobilized HLA class I antigens from donor cells in a glycoprotein‐specific assay. With an absorption‐elution technique, at least anti‐HLA‐A2 could be identified as one of the donor‐reactive antibodies in the recipient's serum. CONCLUSION: Granulocyte‐reactive antibodies are associated with TRALI in an alloimmunized patient receiving granulocyte transfusions. Performing a cross‐match procedure may be helpful in preventing severe pulmonary reactions. Additional data are required to determine whether cross‐matching as a regular practice in granulocyte transfusions would be beneficial for patients.