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Benefit of transfusion‐related acute lung injury risk‐minimization measures – German haemovigilance data (2006–2010)
Author(s) -
Funk M. B.,
Guenay S.,
Lohmann A.,
Henseler O.,
Heiden M.,
Hanschmann K. M. O.,
KellerStanislawski B.
Publication year - 2012
Publication title -
vox sanguinis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.68
H-Index - 83
eISSN - 1423-0410
pISSN - 0042-9007
DOI - 10.1111/j.1423-0410.2011.01556.x
Subject(s) - medicine , immune system , human leukocyte antigen , antibody , transfusion related acute lung injury , fresh frozen plasma , immunology , antigen , platelet , lung , pulmonary edema
Objective Based on the frequency of immune‐mediated and non‐immune‐mediated transfusion‐related acute lung injury (TRALI), the effect of risk‐minimization measures was evaluated during a period of 5 years (2006–2010). Risk‐minimization measures were implemented in 2008/2009, consisting of exclusion of female donors with a history of pregnancy or exclusion of female donors with human leucocyte antigen (HLA)/human neutrophil alloantigen (HNA) antibodies. Methods TRALI was confirmed according to the criteria of the International Haemovigilance Network. Based upon the results of donor testing of white‐blood‐cell antibodies (WBC‐Ab) against HLA or HNAs, confirmed cases were classified as immune‐ or non‐immune‐mediated TRALI. Reporting rates were calculated on the basis of the annually transfused blood components, and pre‐ and post‐implementation periods were compared. Results In total, 60 immune‐mediated (75%) and 20 non‐immune‐mediated (25%) TRALI reactions were confirmed. A total of 68 (64 women and four men) donors were involved: seven red‐blood‐cell concentrates donors (13%), six platelet concentrate donors (10%), and 48 fresh frozen plasma (FFP) donors (77%). The reporting rate of immune‐mediated TRALI caused by FFP decreased continuously; from 12·71 per million units in 2006/2007 to 6·81 per million units in 2008/2009 and no case in 2010. Conclusion The comparison of the pre‐ and the post‐implementation period demonstrated a significantly reduced risk of TRALI events comparing 2006/2007 with 2010 ( P ‐value: < 0·01). Furthermore, no case of TRALI‐induced fatality occurred after the implementation of risk‐minimization measures.