PMID- 15041162
OWN - NLM
STAT- MEDLINE
DCOM- 20041110
LR  - 20041117
IS  - 0198-8859 (Print)
IS  - 0198-8859 (Linking)
VI  - 65
IP  - 3
DP  - 2004 Mar
TI  - Unappreciated risk factors for transplant patients: HLA antibodies in blood 
      components.
PG  - 240-4
AB  - One of the more aggressive approaches in renal transplantation is the use of 
      plasmapheresis (PP) and intravenous immunoglobulin to eliminate donor-directed 
      human leukocyte antigen (HLA) alloantibodies. A potential complication of a PP 
      protocol is iatrogenic hypocoagulability resulting from the removal of 
      coagulation factors. To prevent bleeding, hypocoagulable patients may require 
      transfusions with fresh frozen plasma (FFP) and/or cryoprecipitate (Cryo). 
      Although HLA alloantibodies in these components have been linked to 
      complications, such as transfusion-related acute lung injury (TRALI), whether 
      they cause complications following transfusion into allograft recipients is 
      unknown. The incidence of complications would be dependent, in part, upon the 
      frequency of HLA alloantibodies in the various blood components. In this study, 
      segments from 77 units of FFP, 66 units of Cryo, 106 units of packed red blood 
      cells (RBCs), and 59 units of apheresis platelets (Plts) were tested for 
      antibodies to HLA class I and class II antigens using FlowPRA, an HLA 
      antigen-specific flow cytometric assay. On average, 22% of blood components 
      tested contained HLA alloantibodies, tenfold greater than previously reported. 
      This unappreciated frequency of HLA alloantibodies in blood components may pose a 
      risk to transplant patients requiring transfusions by promoting allograft 
      dysfunction or loss.
FAU - Bray, Robert A
AU  - Bray RA
AD  - Department of Pathology and Laboratory Medicine, Emory University Hospital, 
      Atlanta, GA 30322, United States.
FAU - Harris, Shealynn B
AU  - Harris SB
FAU - Josephson, Cassandra D
AU  - Josephson CD
FAU - Hillyer, Christopher D
AU  - Hillyer CD
FAU - Gebel, Howard M
AU  - Gebel HM
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Hum Immunol
JT  - Human immunology
JID - 8010936
RN  - 0 (Antibodies)
RN  - 0 (Isoantibodies)
RN  - 0 (cryoprecipitate coagulum)
RN  - 9001-27-8 (Factor VIII)
RN  - 9001-32-5 (Fibrinogen)
SB  - IM
MH  - Antibodies/*immunology
MH  - Blood Component Transfusion/*adverse effects
MH  - Blood Platelets/immunology
MH  - Erythrocytes/immunology
MH  - Factor VIII/immunology
MH  - Fibrinogen/immunology
MH  - Humans
MH  - Isoantibodies/*immunology
MH  - Kidney Transplantation/*adverse effects/immunology
MH  - Plasma/immunology
EDAT- 2004/03/26 05:00
MHDA- 2004/11/13 09:00
CRDT- 2004/03/26 05:00
PHST- 2003/12/10 00:00 [received]
PHST- 2003/12/22 00:00 [accepted]
PHST- 2004/03/26 05:00 [pubmed]
PHST- 2004/11/13 09:00 [medline]
PHST- 2004/03/26 05:00 [entrez]
AID - S0198885904000047 [pii]
AID - 10.1016/j.humimm.2003.12.007 [doi]
PST - ppublish
SO  - Hum Immunol. 2004 Mar;65(3):240-4. doi: 10.1016/j.humimm.2003.12.007.