[Identification of anti-HLA-A1 antibodies in a multi-transfused patient--case report]

HLA antibodies develop as a result of alloimmunization to HLA class I and II antigens. Their appearance is associated with frequent blood transfusions, allogeneic tissue and organ transplantation, pregnancy and immunization. It is established that after usage of single dose HLA nonmatched leukocytes, circulating lymphocytotoxic antibodies appear in serum of recipients, 10 to 12 days after alloimmunization.

This article describes a case report of a multi-transfused patient, with identified HLA-A1 antibodies established by using microlymphocytotoxicity test and two different panels of HLA typed lymphocytes. The case report shows occurrence of febrile posttransfusion nonhemolytic reaction (FNHTR) in our patient after application of 410 ml resuspended erythrocytes. After transfusiologists recommendations for detecting lymphocytotoxic antibodies in patient's serum, we determined a specificity of monospecific antibody which caused posttransfusion FNHTR.

FNHTR may be caused by antileukocyte antibodies or immunoinflammatory cytokines. It is more frequent in patients receiving platelet concentrates (15-30%) than those receiving red blood cell products (1%). This case report shows that FNHTR was caused by HLA-A1 antibody in a patient who received 111 various blood products.