BACKGROUND: We used a multicenter retrospective cohort study design to evaluate whether human leukocyte antigen (HLA) antibody donor screening would reduce the risk of transfusion-related acute lung injury (TRALI) or possible TRALI. STUDY DESIGN AND METHODS: In the Leukocyte Antibody Prevalence Study-II (LAPS-II), we evaluated pulmonary outcomes in recipients of 2596 plasma-rich blood components (transfusable plasma and plateletpheresis) sent to participating hospitals; half of the components were collected from anti-HLA-positive donors (study arm) and half from anti-HLA-negative donors (control arm) matched by sex, parity, and blood center. A staged medical record review process was used. Final recipient diagnosis was based on case review by a blinded expert panel of pulmonary or critical care physicians. RESULTS: TRALI incidence was 0.59% (seven cases) in study arm recipients versus 0.16% (two cases) in control arm recipients for an odds ratio (OR) of 3.6 (95% confidence interval [CI], 0.7-17.4; p = 0.10). For possible TRALI cases (nine study arm, eight control arm), the OR was 1.2 (95% CI, 0.4-3.0; p = 0.81), and for TRALI and possible TRALI aggregated together, it was 1.7 (95% CI, 0.7-3.7; p = 0.24). Transfusion-associated circulatory overload incidence was identical in the two arms (1.17 and 1.22%, respectively; OR, 1.0; p = 1.0). CONCLUSIONS: TRALI incidence in recipients of anti-HLA-positive components was relatively low for a lookback study (1 in 170) and was higher than in the control arm, but did not reach significance. Based on this trend, the data are consistent with the likelihood that TRALI risk is decreased by selecting high-volume plasma components for transfusion from donors at low risk of having HLA antibodies.
BACKGROUND: We used a multicenter retrospective cohort study design to evaluate whether human leukocyte antigen (HLA) antibody donor screening would reduce the risk of transfusion-related acute lung injury (TRALI) or possible TRALI. STUDY DESIGN AND METHODS: In the Leukocyte Antibody Prevalence Study-II (LAPS-II), we evaluated pulmonary outcomes in recipients of 2596 plasma-rich blood components (transfusable plasma and plateletpheresis) sent to participating hospitals; half of the components were collected from anti-HLA-positive donors (study arm) and half from anti-HLA-negative donors (control arm) matched by sex, parity, and blood center. A staged medical record review process was used. Final recipient diagnosis was based on case review by a blinded expert panel of pulmonary or critical care physicians. RESULTS: TRALI incidence was 0.59% (seven cases) in study arm recipients versus 0.16% (two cases) in control arm recipients for an odds ratio (OR) of 3.6 (95% confidence interval [CI], 0.7-17.4; p = 0.10). For possible TRALI cases (nine study arm, eight control arm), the OR was 1.2 (95% CI, 0.4-3.0; p = 0.81), and for TRALI and possible TRALI aggregated together, it was 1.7 (95% CI, 0.7-3.7; p = 0.24). Transfusion-associated circulatory overload incidence was identical in the two arms (1.17 and 1.22%, respectively; OR, 1.0; p = 1.0). CONCLUSIONS: TRALI incidence in recipients of anti-HLA-positive components was relatively low for a lookback study (1 in 170) and was higher than in the control arm, but did not reach significance. Based on this trend, the data are consistent with the likelihood that TRALI risk is decreased by selecting high-volume plasma components for transfusion from donors at low risk of having HLA antibodies.
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: Nareg H Roubinian; Mark R Looney; Sheila Keating; Daryl J Kor; Clifford A Lowell; Ognjen Gajic; Rolf Hubmayr; Michael Gropper; Monique Koenigsberg; Gregory A Wilson; Michael A Matthay; Pearl Toy; Edward L Murphy Journal: Transfusion Date: 2017-05-03 Impact factor: 3.157
Authors: Nareg H Roubinian; Mark R Looney; Daryl J Kor; Clifford A Lowell; Ognjen Gajic; Rolf D Hubmayr; Michael A Gropper; Monique Koenigsberg; Gregory A Wilson; Michael A Matthay; Pearl Toy; Edward L Murphy Journal: Transfusion Date: 2015-02-23 Impact factor: 3.157
Authors: Mark R Looney; Nareg Roubinian; Ognjen Gajic; Michael A Gropper; Rolf D Hubmayr; Clifford A Lowell; Peter Bacchetti; Gregory Wilson; Monique Koenigsberg; Deanna C Lee; Ping Wu; Barbara Grimes; Philip J Norris; Edward L Murphy; Manish J Gandhi; Jeffrey L Winters; David C Mair; Randy M Schuller; Nora V Hirschler; Rosa Sanchez Rosen; Michael A Matthay; Pearl Toy Journal: Crit Care Med Date: 2014-07 Impact factor: 7.598
Authors: Pearl Toy; Peter Bacchetti; Barbara Grimes; Ognjen Gajic; Edward L Murphy; Jeffrey L Winters; Michael A Gropper; Rolf D Hubmayr; Michael A Matthay; Gregory Wilson; Monique Koenigsberg; Deanna C Lee; Nora V Hirschler; Clifford A Lowell; Randy M Schuller; Manish J Gandhi; Philip J Norris; David C Mair; Rosa Sanchez Rosen; Mark R Looney Journal: Transfusion Date: 2014-12-08 Impact factor: 3.157
Authors: Pearl Toy; Mark R Looney; Mark Popovsky; Miodrag Palfi; Gösta Berlin; Catherine E Chapman; Paula Bolton-Maggs; Michael A Matthay Journal: Ann Am Thorac Soc Date: 2022-05