possible TRALI
症状：１－２時間以内に遅くとも６時間までに発症
抗HLA抗体、抗顆粒球抗体と白血球の抗原抗体反応により保体が活性化され、好中球が活性化される
FFPやPCで多い
女性からのドナーに多い
血小板減少とFFP投与が危険因子
高齢者と人工心肺はリスク
女性の血漿を排除することでTRALIの減少につながった
妊娠により女性血液中に作られた抗体が由来するのか
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調べてみた
Transfusion. 2014 27. doi: 10.1111/trf.12727. [Epub ahead of print]
Screening for HLA antibodies in plateletpheresis donors with a history of
transfusion or pregnancy.
De Clippel D(1), Baeten M, Torfs A, Emonds MP, Feys HB, Compernolle V,
Vandekerckhove P.
A history of transfusion is a minor risk factor for immunization against HLA antigens.
In contrast, former pregnancies constitute a major risk factor for the development of HLA antibodies.
Since HLA alloimmunization rate increases with parity,
TRALI risk reduction measures should focus on this particular donor population.
Screening for HLA antibodies in plateletpheresis donors with a history of
transfusion or pregnancy.
De Clippel D(1), Baeten M, Torfs A, Emonds MP, Feys HB, Compernolle V,
Vandekerckhove P.
A history of transfusion is a minor risk factor for immunization against HLA antigens.
In contrast, former pregnancies constitute a major risk factor for the development of HLA antibodies.
Since HLA alloimmunization rate increases with parity,
TRALI risk reduction measures should focus on this particular donor population.
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