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Clinical and Developmental Immunology logoLink to Clinical and Developmental Immunology
. 2005 Dec;12(4):243–248. doi: 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

Hélène Odent-Malaure 1, Fabienne Quainon 1, Pascale Ruyer-Dumontier 1, Soizick Ducroz 2, Philippe Verdier 2, Evelyne Voitellier 3, Marie-Françoise Raynal 3, Patricia Fromont 4, Jean-Yves Muller 4, Danielle Rebibo 5, Léna Absi 1, Olivier Garraud 1
PMCID: PMC2270739  PMID: 16584109

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.

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