Sinnott P, Bodger S, Gupta A, Brophy M
Tissue Typing Laboratory, Royal London Hospital Barts and the London NHS Trust, London, UK.
Eur J Immunogenet. 2004 Dec;31(6):271-4. doi: 10.1111/j.1365-2370.2004.00481.x.
Adverse reactions to plasma transfusion are well documented. One of the most serious hazards of transfusion, transfusion-related acute lung injury (TRALI), has nearly as high an incidence of mortality and major morbidity as that reported for the transfusion of incorrect blood components. The specific mechanisms of plasma component-induced adverse reactions remain unclear, but a major contribution may be related to the presence of alloantibodies. In this study, a laboratory analysis was undertaken to determine the presence of HLA antibodies in leucodepleted single-donor-derived fresh frozen plasma (FFP). A comparison was made with a pooled plasma product that has undergone solvent detergent treatment. In total, 58 plasma samples from single-donor units of leucodepleted FFP were tested along with samples from 12 units (three for each ABO blood group) of the pooled plasma (Octaplas); Octapharma Ltd, Coventry, UK), for the presence of HLA antibodies. HLA-specific enzyme-linked immunosorbent assay (ELISA) methods were used to screen for their presence, and complement-dependent cytotoxicity and flow cytometry analyses were used to further define their presence, specificity and class [immunoglobulin G (IgG)/IgM]. In the study groups, HLA antibodies were found to be present in five of the single-donor units (9%) while the pooled plasma samples tested negative.
血浆输注的不良反应已有充分记录。输血最严重的危害之一，即输血相关急性肺损伤（TRALI），其死亡率和主要发病率几乎与输注错误血液成分所报告的情况一样高。血浆成分引起不良反应的具体机制尚不清楚，但主要原因可能与同种抗体的存在有关。在本研究中，进行了一项实验室分析，以确定白细胞滤除的单供体来源新鲜冰冻血浆（FFP）中HLA抗体的存在情况。并与经过溶剂去污剂处理的混合血浆产品进行了比较。总共检测了58份来自白细胞滤除FFP单供体单位的血浆样本，以及来自12个单位（每个ABO血型三个）混合血浆（Octaplas；英国考文垂奥克塔法马有限公司）的样本，以检测HLA抗体的存在情况。采用HLA特异性酶联免疫吸附测定（ELISA）方法筛选其存在情况，并采用补体依赖细胞毒性和流式细胞术分析进一步确定其存在情况、特异性和类别[免疫球蛋白G（IgG）/IgM]。在研究组中，发现5个单供体单位（9%）存在HLA抗体，而混合血浆样本检测为阴性。
