Sunday, February 2, 2020

TRALI and Females

Q: To mitigate the side effect of Transfusion-related Acute Lung Injury (TRALI) deferral of female donors shown to have a favorable effect. Deferral of which female population has shown a better outcome? 

A) nulliparous 
B) multiparous

Answer: B

After a dramatic rise (awareness) of TRALI, "TRALI mitigation strategies" have been adopted by blood banks and has shown many favorable outcomes. One strategy is to defer the multiparous female donors for plasma transfusion. It was found that there is a dose-response increase in the frequency of anti-HLA antibodies according to parity, from 1.7 percent for never pregnant females to 32.2 percent for four or more pregnancies (reference#4).




1. Chapman CE, Stainsby D, Jones H, et al. Ten years of hemovigilance reports of transfusion-related acute lung injury in the United Kingdom and the impact of preferential use of male donor plasma. Transfusion 2009; 49:440.

2. Eder AF, Herron RM Jr, Strupp A, et al. Effective reduction of transfusion-related acute lung injury risk with male-predominant plasma strategy in the American Red Cross (2006-2008). Transfusion 2010; 50:1732. 
3. Lucas G, Win N, Calvert A, et al. Reducing the incidence of TRALI in the UK: the results of screening for donor leucocyte antibodies and the development of national guidelines. Vox Sang 2012; 103:10.

4. Triulzi DJ, Kleinman S, Kakaiya RM, et al. The effect of previous pregnancy and transfusion on HLA alloimmunization in blood donors: implications for a transfusion-related acute lung injury risk reduction strategy. Transfusion 2009; 49:1825.

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