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A Simple Double Centrifugation Tube Method to Obtain Platelet-rich Plasma from Equine Blood

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How much residual plasma may cause TRALI?

N Win¹, C E Chapman, K M Bowles

¹Red Cell Immunology Department, National Blood Service, Tooting Centre, London. nay.win@nhsbt.nhs.uk

Transfusion Medicine (Oxford, England)

|October 22, 2008

Summary

This summary is machine-generated.

Even small volumes of residual plasma (10-20 mL) containing white blood cell (WBC) antibodies can cause transfusion-related acute lung injury (TRALI). This risk persists even with pooled platelets in male plasma, highlighting antibody presence as key.

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Basic Research in Plasma Medicine - A Throughput Approach from Liquids to Cells

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Area of Science:

Hematology
Immunology
Transfusion Medicine

Background:

Transfusion-related acute lung injury (TRALI) is a serious adverse event often linked to passive antibody transfer.
The minimum volume of residual plasma triggering TRALI remains undetermined, posing a risk in component transfusions.

Observation:

Three TRALI cases were identified involving residual plasma volumes of 10-20 mL.
Affected components included red blood cells and pooled buffy coat platelets.
Donor serum contained multiple human leucocyte antigen (HLA) antibodies matching patient HLA types.

Findings:

Residual plasma as low as 10-20 mL, containing donor-derived WBC antibodies, can induce TRALI.
Pooled platelets suspended in male plasma did not eliminate TRALI risk if antibody presence was high.
Multiple HLA antigen/antibody mismatches between donor and recipient are significant in immune TRALI.

Implications:

Clinicians should consider the risk of TRALI even with minimal residual plasma volumes.
Current strategies for pooled platelet preparation may not fully mitigate TRALI risk.
Further research into HLA matching is crucial for preventing immune-mediated TRALI.