BACKGROUND: Transfusion-related acute lung injury (TRALI) is the leading cause of transfusion-related deaths. Donor HLA antibodies have been implicated in TRALI cases. Blood centers are implementing TRALI risk reduction strategies based on HLA antibody screening of some subpopulations of ever-pregnant apheresis platelet (PLT) donors. However, if screening assay cutoffs are too sensitive, donation loss may adversely impact blood availability. STUDY DESIGN AND METHODS: Pregnancy history and HLA antibody screening and single-antigen bead data from blood donors in the Retrovirus Epidemiology Donor Study-II Leukocyte Antibody Prevalence Study were evaluated for correlations between assay screening values, HLA antibody titer, and number of HLA antigen specificities. The probabilities of matching a cognate antigen in a recipient were calculated and examined in association with total number of specificities observed and screening values. The relative impact of imposing various screening assay cutoffs or pregnancy stratification was examined in relation to detection of HLA antibody-reactive donations and loss of donors and donations. RESULTS: We provide evidence that higher HLA antibody screening assay values are associated with maintaining higher screening signals upon dilution and an increased breadth of specificities compared with lower screening values; the latter correlated with an increased risk of a cognate antigen match in potential recipients. Depending on the TRALI risk reduction strategy used, the potential loss of donations ranged between 0.9 and 6.0%. CONCLUSION: This analysis should enable blood centers to decide upon a TRALI risk reduction strategy for apheresis PLTs that is consistent with how much donation loss the blood center can tolerate.
BACKGROUND: Transfusion-related acute lung injury (TRALI) is the leading cause of transfusion-related deaths. Donor HLA antibodies have been implicated in TRALI cases. Blood centers are implementing TRALI risk reduction strategies based on HLA antibody screening of some subpopulations of ever-pregnant apheresis platelet (PLT) donors. However, if screening assay cutoffs are too sensitive, donation loss may adversely impact blood availability. STUDY DESIGN AND METHODS: Pregnancy history and HLA antibody screening and single-antigen bead data from blood donors in the Retrovirus Epidemiology Donor Study-II Leukocyte Antibody Prevalence Study were evaluated for correlations between assay screening values, HLA antibody titer, and number of HLA antigen specificities. The probabilities of matching a cognate antigen in a recipient were calculated and examined in association with total number of specificities observed and screening values. The relative impact of imposing various screening assay cutoffs or pregnancy stratification was examined in relation to detection of HLA antibody-reactive donations and loss of donors and donations. RESULTS: We provide evidence that higher HLA antibody screening assay values are associated with maintaining higher screening signals upon dilution and an increased breadth of specificities compared with lower screening values; the latter correlated with an increased risk of a cognate antigen match in potential recipients. Depending on the TRALI risk reduction strategy used, the potential loss of donations ranged between 0.9 and 6.0%. CONCLUSION: This analysis should enable blood centers to decide upon a TRALI risk reduction strategy for apheresis PLTs that is consistent with how much donation loss the blood center can tolerate.
Authors: Robert O Endres; Steven H Kleinman; Danielle M Carrick; Whitney R Steele; David J Wright; Philip J Norris; Darrell Triulzi; Ram Kakaiya; Michael P Busch Journal: Transfusion Date: 2010-02-11 Impact factor: 3.157
Authors: Philip J Norris; Jar-How Lee; Danielle M Carrick; Jerome L Gottschall; Mila Lebedeva; B R de Castro; Steven H Kleinman; Michael P Busch Journal: Transfusion Date: 2008-10-29 Impact factor: 3.157
Authors: Ram M Kakaiya; Darrell J Triulzi; David J Wright; Whitney R Steele; Steven H Kleinman; Michael P Busch; Philip J Norris; Christopher D Hillyer; Jerome L Gottschall; Jorge A Rios; Patricia Carey; Simone A Glynn Journal: Transfusion Date: 2010-01-08 Impact factor: 3.157
Authors: Darrell J Triulzi; Steven Kleinman; Ram M Kakaiya; Michael P Busch; Philip J Norris; Whitney R Steele; Simone A Glynn; Christopher D Hillyer; Patricia Carey; Jerome L Gottschall; Edward L Murphy; Jorge A Rios; Paul M Ness; David J Wright; Danielle Carrick; George B Schreiber Journal: Transfusion Date: 2009-05-18 Impact factor: 3.157
Authors: Pearl Toy; Ognjen Gajic; Peter Bacchetti; Mark R Looney; Michael A Gropper; Rolf Hubmayr; Clifford A Lowell; Philip J Norris; Edward L Murphy; Richard B Weiskopf; Gregory Wilson; Monique Koenigsberg; Deanna Lee; Randy Schuller; Ping Wu; Barbara Grimes; Manish J Gandhi; Jeffrey L Winters; David Mair; Nora Hirschler; Rosa Sanchez Rosen; Michael A Matthay Journal: Blood Date: 2011-11-23 Impact factor: 22.113
Authors: Manish J Gandhi; Danielle M Carrick; Sarah Jenkins; Steven De Goey; Nancy A Ploeger; Gregory A Wilson; Jar How Lee; Jeffrey L Winters; James R Stubbs; Pearl Toy; Philip J Norris Journal: Transfusion Date: 2013-01-10 Impact factor: 3.157
Authors: Rachael P Jackman; Giovanna I Cruz; Joanne Nititham; Darrell J Triulzi; Lisa F Barcellos; Lindsey A Criswell; Philip J Norris; Michael P Busch Journal: Lupus Sci Med Date: 2018-09-25