A preliminary comparison of the prevalence of transfusion reactions in recipients of platelet components from donors with and without human leucocyte antigen antibodies
A preliminary comparison of the prevalence of transfusion reactions in recipients of platelet components from donors with and without human leucocyte antigen antibodies
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DOI：
10.1111/j.1423-0410.2008.01041.x
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发表时间：
2008-01-01
期刊：
影响因子：
2.7
通讯作者：
Stroncek, D. F.
中科院分区：
文献类型：
--
作者：
Fadeyi, E. A.;Adams, S.;Stroncek, D. F.
人类白细胞抗原（HLA）抗体与输血相关的急性肺损伤有关，但含有HLA抗体的血液成分输血引起反应的可能性尚不清楚。本研究比较了输注有HLA抗体和不含HLA抗体的血小板成分相关反应的发生率。研究设计和方法本回顾性研究检测了96个连续的单采血小板供者的HLA I类和II类抗体。选择匹配的没有HLA抗体的对照供者，并审查记录以确定每组引起反应的成分的比例。此外，所有参与两种或两种以上反应的单采血小板供者都被鉴定并检测HLA I类抗体。结果96例献血者中有5例有ⅰ类或ⅱ类抗原抗体，其中4例有输血成分。这4名HLA抗体供者和12名无抗体的对照供者的反应发生率相似（167次输血有3次反应，占1.8%；3次输血有295次反应，占1.0%,P = 0.32）。对所有血小板献血者输血记录的回顾性分析发现，22名献血者的成分引起两种或两种以上的反应，3名（13.6%）有HLA I类抗体，而连续选择的献血者中这一比例为4.2% （P = 0.12）。所有患者均无输血相关急性肺损伤。结论含有HLA抗体的单采血小板输注引起的反应并不常见。
Background Human leucocyte antigen (HLA) antibodies have been implicated in transfusion-related acute lung injury, but the probability that the transfusion of a blood component containing HLA antibodies will cause a reaction is not known. This study compared the prevalence of reactions associated with the transfusion of platelet components with and without HLA antibodies.Study Design and Methods This retrospective study tested 96 consecutive apheresis platelet donors for HLA class I and II antibodies. Matched control donors without HLA antibodies were selected and records were reviewed to determine the proportion of components from each group that caused reactions. In addition, all apheresis platelet donors involved with two or more reactions were identified and tested for HLA class I antibodies.Results Five of the 96 donors had antibodies to class I or class II antigens and, of these, four had components transfused. The prevalence of reactions to components from these four donors with HLA antibodies and the 12 matched control donors without antibodies was similar (three reactions to 167 transfusions or 1.8% vs. three to 295 or 1.0%, respectively, P = 0.32). A retrospective review of the transfusion records from all platelet donors found that components from 22 caused two or more reactions and three (13.6%) had antibodies to HLA class I compared to 4.2% of the consecutively selected donors (P = 0.12). None of the patients experienced transfusion-related acute lung injury.Conclusion Reactions associated with transfusion of apheresis platelets containing HLA antibodies are unusual.