Transfusion-related acute lung injury (TRALI): a review of investigations by the National Tissue Typing Laboratory of cases reported in New Zealand since June 2004.

AIM

To review investigations of reported cases of Transfusion-Related Acute Lung Injury (TRALI) performed by the National Tissue Typing laboratory since 2004.

METHOD

Donors associated with reported cases of TRALI are recalled for white cell antibody tests. A donor is implicated if found to have neutrophil or HLA antibodies with specificity against one of the recipient's HLA antigens, or a positive white cell crossmatch. A retrospective review of investigations performed by the Tissue Typing Laboratory on TRALI cases from June 2004 to June 2007 was undertaken.

RESULTS

Seventeen cases of TRALI had tests performed by the Tissue Typing Laboratory over the 3-year period. A total of 67 donors were tested. Twenty-nine donors had a positive HLA-antibody screen and the majority of these were female (86%, with fresh frozen plasma (FFP) the commonest component type (41%). In 15 (88%) cases, HLA antibodies were found in donor sera and nine of these had specificity against patient HLA antigen or a positive crossmatch.

CONCLUSION

Preliminary data on TRALI investigations concur with overseas studies. Raising awareness of this hazard of transfusion and a consistent approach in investigation of TRALI will allow us to gain further insight into this complication in New Zealand and consequently explore strategies to prevent such adverse transfusion reactions.