Antibody-mediated (immune) transfusion-related acute lung injury.

Antibody-mediated transfusion-related acute lung injury (immune TRALI) is now recognized as the most common cause of transfusion-associated major morbidity and death in the Western world. Among the implicated leucocyte antibodies, these ones directed against the human leucocyte antigens (HLA) class II, human neutrophil alloantigens (HNA)-3a and HLA-A2 antigens are frequently associated with severe (artificial ventilation required) and fatal cases. There is accumulating evidence that preventive measures such as transfusion of plasma-rich blood components from male donors or from donors tested negative for leucocyte antibodies are effective in the reduction of severe and fatal immune TRALI.