Department of Immunology, Oslo University Hospital, Oslo, Norway.
Department of Immunology, Oslo University Hospital, Oslo, Norway.
Transfus Apher Sci. 2022 Oct;61(5):103567. doi: 10.1016/j.transci.2022.103567. Epub 2022 Aug 30.
Transfusion of HLA-specific antibodies may play a role in induction of TRALI, the transfusion complication responsible for most transfusion-related deaths. In Oslo, we screen our apheresis donors and defer HLA-immunized donors from donation of plasma-rich blood components. During the second year of the Covid-19 pandemic and following the first months of SARS-CoV-2 vaccination, both the virus itself and the vaccines were suspected of inducing de novo production of antibodies to HLA class I in patients. For the blood center, the possibility of finding HLA-antibodies in an increased number of blood donors has serious implications. We therefore conducted a study to map the extent of de novo HLA-specific antibodies in representative donor groups. 106 apheresis donors were screened for antibodies to HLA class I/II following Covid-19 or vaccination with either mRNA or adenovirus-vector vaccines, and the findings were compared to pre-Covid blood samples from the same donors. In addition, we analyzed pre-Covid samples from 11 HLA-antibody-positive donors of Covid convalescence plasma. Only three established thrombapheresis donors were deferred due to vaccine-induced HLA-antibodies. In short, our findings did not support the hypothesis that SARS-CoV-2 virus or vaccination cause de novo HLA immunization in healthy blood donors. However, some donors with pre-existing antibodies showed increased antibody expression, confirming a general boost of the immune response following infection or vaccination.
输注 HLA 特异性抗体可能在诱导 TRALI 中起作用，TRALI 是导致大多数输血相关死亡的输血并发症。在奥斯陆，我们对我们的单采献血者进行筛查，并推迟 HLA 免疫献血者捐献富含血浆的血液成分。在 COVID-19 大流行的第二年以及 SARS-CoV-2 疫苗接种的头几个月，病毒本身和疫苗都被怀疑在患者中诱导新产生针对 HLA Ⅰ类的抗体。对于血液中心来说，在更多的献血者中发现 HLA 抗体的可能性具有严重的影响。因此，我们进行了一项研究，以描绘代表献血者群体中 HLA 特异性抗体的程度。在 COVID-19 之后或接种 mRNA 或腺病毒载体疫苗后，对 106 名单采献血者进行了 HLA Ⅰ/Ⅱ类抗体筛查，并将结果与同一献血者的 COVID 前血液样本进行了比较。此外，我们还分析了 11 名 COVID 恢复期血浆 HLA 抗体阳性献血者的 COVID 前样本。仅因疫苗诱导的 HLA 抗体而推迟了 3 名既定的血栓切除术献血者。简而言之，我们的研究结果并不支持 SARS-CoV-2 病毒或疫苗在健康献血者中引起新的 HLA 免疫的假说。然而，一些具有预先存在抗体的献血者表现出抗体表达增加，证实了感染或接种疫苗后免疫反应的普遍增强。
