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Clinical and Developmental Immunology
Volume 12 (2005), Issue 4, Pages 243-248
http://dx.doi.org/10.1080/17402520500307926

Transfusion Related Acute Lung Injury (TRALI) Caused by Red Blood Cell Transfusion Involving Residual Plasma Anti-HLA Antibodies: A report on two Cases and General Considerations

1Etablissement Français du Sang Auvergne, Loire, France
2Centre Hospitalier de Montluçon, Montluçon, France
3Centre Hospitalier de Vichy, Vichy, France
4Laboratoire d'Immunologie, CHU de Nantes, Nantes, France
5Etablissement Français du Sang, Direction Médicale et Scientifique, Paris, France

Copyright © 2005 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

TRALI is considered a serious hazard among immune complications of blood transfusion and its occurrence is admitted to be globally underestimated. Each type of blood product is likely to cause TRALI. We report here on two consecutive observations of TRALI caused by red blood cell concentrates, in which anti-HLA class I and class II antibodies resulting from post-gravitational allo-immunization were evidenced in donors. HLA class I and II antigenic community between recipients and donors' husbands were found and strong reacting IgG antibodies directed at several of those common antigens were detected in the donors' serum. Both donors had more than 3 pregnancies, raising the issue of blood donor selection or of plasma reduction for cellular products.