Transfusion-related acute lung injury (TRALI) is a serious and potentially fatal transfusion reaction. The majority of TRALI cases may be triggered by passive transfer of HLA or neutrophil-specific antibodies. In a subset of cases, the causative antibodies are present in the recipient and react with transfused cellular material. Contrasting plasma samples between donor(s) and patient can be very helpful in the evaluation of a suspected TRALI case and is critical for appropriate donor management. Symptoms of TRALI usually develop within 2 hours of transfusion. TRALI is the leading cause of transfusion-related mortality rates and accounts for 13% of all transfusion deaths reported to the FDA.
     Some clinically important antibodies are missed by traditional lymphocytotoxic assays. Flow cytometry is a highly sensitive method for the detection of neutrophil antibodies and HLA antibodies. Neutrophil-antibody testing is complex, labor intensive, and typically performed only in specialized reference laboratories. The Platelet and Neutrophil Immunology Laboratory at BloodCenter of Wisconsin performs complete flow cytometric testing for detection of neutrophil antibodies and HLA Class I & II antibodies in donor and patient plasma.

BloodCenter of Wisconsin
(800) 245-3117; www.bcw.edu