|
1
|
Guz K, Łopacz P, Uhrynowska M, Piaskowska K, Szczepaniak B, Krzemienowska M, Purchla-Szepioła S, Główka A, Głodkowska-Mrówka E, Orzińska A. Anti-HNA testing of allo-exposed COVID-19 convalescent plasma donors including genetic human neutrophil antigen screening to prevent anti-HNA antibody-mediated transfusion-related acute lung injury. Transfusion 2024; 64:1703-1708. [PMID: 39044618 DOI: 10.1111/trf.17962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 06/05/2024] [Accepted: 07/04/2024] [Indexed: 07/25/2024]
Abstract
BACKGROUND Transfusion-related acute lung injury caused by antibodies against human neutrophil antigens (HNA) is a serious but rare complication associated with blood transfusion. The presence of such antibodies is most probable in donors with a transfusion/pregnancy history. During the COVID-19 pandemic period convalescent plasma (CP) containing neutralizing antibodies against SARS-CoV-2 was widely used for COVID-19 patients as a therapy in the absence of any treatment. The aim of the study was to work out a simple diagnostic algorithm of anti-HNA testing of allo-exposed CP donors including genetic HNA screening. MATERIALS AND METHODS A total of 457 anti-HLA-negative allo-exposed CP donors were genotyped for HNA-1a/1b, HNA-3a/3b, and HNA-2, and only donors with homozygous HNA-1a/1a; HNA-3b/3b; or HNA-2null genotypes were tested for anti-HNA antibody using LabScreenMulti (One Lambda) and homozygous HNA-1b/1b using the granulocyte immunofluorescence test (GIFT) but verified using LabScreenMulti. RESULTS Testing of 83 homozygous HNA-3b/3b; HNA-2null; or HNA-1a/1a donors revealed anti-HNA-3a antibody in one case. Testing of 181 HNA-1b/1b donors using GIFT gave 10 ambiguous results verified using LabScreenMulti which confirmed anti-HNA-1a antibody in one case. The frequency of FCGR3B*01 and *04 encoding HNA-1a was 0.34; FCGR3B*02, *03, and *05 encoding HNA-1b-0.66; SLC44A2*01 encoding HNA-3a-0.80; and SLC44A2*02 encoding HNA-3b-0.20. In 3.7% cases the HNA-2null genotype was revealed. DISCUSSION Due to applying HNA genotyping as a primary test before anti-HNA antibody testing the serological work was limited only to HNA-homozygous donors revealing two anti-HNA immunized donors. The distribution of HNA genotypes in the cohort was similar to other Caucasian populations.
Collapse
Affiliation(s)
- Katarzyna Guz
- Department of Hematological and Transfusion Immunology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | - Patrycja Łopacz
- Department of Hematological and Transfusion Immunology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | - Małgorzata Uhrynowska
- Department of Hematological and Transfusion Immunology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | - Karolina Piaskowska
- Department of Hematological and Transfusion Immunology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | - Beata Szczepaniak
- Department of Hematological and Transfusion Immunology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | - Magdalena Krzemienowska
- Department of Hematological and Transfusion Immunology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | - Sylwia Purchla-Szepioła
- Department of Hematological and Transfusion Immunology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | - Anna Główka
- Department of Hematological and Transfusion Immunology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | - Eliza Głodkowska-Mrówka
- Department of Hematological and Transfusion Immunology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | - Agnieszka Orzińska
- Department of Hematological and Transfusion Immunology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| |
Collapse
|
|
2
|
Yu Y, Lian Z. Update on transfusion-related acute lung injury: an overview of its pathogenesis and management. Front Immunol 2023; 14:1175387. [PMID: 37251400 PMCID: PMC10213666 DOI: 10.3389/fimmu.2023.1175387] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 04/27/2023] [Indexed: 05/31/2023] Open
Abstract
Transfusion-related acute lung injury (TRALI) is a severe adverse event and a leading cause of transfusion-associated death. Its poor associated prognosis is due, in large part, to the current dearth of effective therapeutic strategies. Hence, an urgent need exists for effective management strategies for the prevention and treatment of associated lung edema. Recently, various preclinical and clinical studies have advanced the current knowledge regarding TRALI pathogenesis. In fact, the application of this knowledge to patient management has successfully decreased TRALI-associated morbidity. This article reviews the most relevant data and recent progress related to TRALI pathogenesis. Based on the existing two-hit theory, a novel three-step pathogenesis model composed of a priming step, pulmonary reaction, and effector phase is postulated to explain the process of TRALI. TRALI pathogenesis stage-specific management strategies based on clinical studies and preclinical models are summarized with an explication of their models of prevention and experimental drugs. The primary aim of this review is to provide useful insights regarding the underlying pathogenesis of TRALI to inform the development of preventive or therapeutic alternatives.
Collapse
Affiliation(s)
| | - Zhengqiu Lian
- Department of Blood Transfusion, The Third People’s Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu, China
| |
Collapse
|
|
3
|
Glatt TN, Hilton C, Nyoni C, Swarts A, Swanevelder R, Cowley J, Mmenu C, Moyo-Gwete T, Moore PL, Kutama M, Jaza J, Phayane I, Brits T, Koekemoer J, Jentsch U, Nelson D, van den Berg K, Vermeulen M. Rapid and Successful Implementation of a COVID-19 Convalescent Plasma Programme-The South African Experience. Viruses 2021; 13:2050. [PMID: 34696480 PMCID: PMC8539971 DOI: 10.3390/v13102050] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 10/04/2021] [Accepted: 10/04/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND COVID-19 convalescent plasma (CCP) has been considered internationally as a treatment option for COVID-19. CCP refers to plasma collected from donors who have recovered from and made antibodies to SARS-CoV-2. To date, convalescent plasma has not been collected in South Africa. As other investigational therapies and vaccination were not widely accessible, there was an urgent need to implement a CCP manufacture programme to service South Africans. METHODS The South African National Blood Service and the Western Cape Blood Service implemented a CCP programme that included CCP collection, processing, testing and storage. CCP units were tested for SARS-CoV-2 Spike ELISA and neutralising antibodies and routine blood transfusion parameters. CCP units from previously pregnant females were tested for anti-HLA and anti-HNA antibodies. RESULTS A total of 987 CCP units were collected from 243 donors, with a median of three donations per donor. Half of the CCP units had neutralising antibody titres of >1:160. One CCP unit was positive on the TPHA serology. All CCP units tested for anti-HLA antibodies were positive. CONCLUSION Within three months of the first COVID-19 diagnosis in South Africa, a fully operational CCP programme was set up across South Africa. The infrastructure and skills implemented will likely benefit South Africans in this and future pandemics.
Collapse
Affiliation(s)
- Tanya Nadia Glatt
- Medical Division, South African National Blood Service, Roodepoort 1709, South Africa; (C.N.); (A.S.); (R.S.); (U.J.); (D.N.); (K.v.d.B.)
| | - Caroline Hilton
- Medical Division, Western Cape Blood Service, Cape Town 7405, South Africa;
| | - Cynthia Nyoni
- Medical Division, South African National Blood Service, Roodepoort 1709, South Africa; (C.N.); (A.S.); (R.S.); (U.J.); (D.N.); (K.v.d.B.)
| | - Avril Swarts
- Medical Division, South African National Blood Service, Roodepoort 1709, South Africa; (C.N.); (A.S.); (R.S.); (U.J.); (D.N.); (K.v.d.B.)
| | - Ronel Swanevelder
- Medical Division, South African National Blood Service, Roodepoort 1709, South Africa; (C.N.); (A.S.); (R.S.); (U.J.); (D.N.); (K.v.d.B.)
| | - James Cowley
- Operations Division, South African National Blood Service, Roodepoort 1709, South Africa; (J.C.); (C.M.); (M.K.); (J.J.); (I.P.); (M.V.)
| | - Cordelia Mmenu
- Operations Division, South African National Blood Service, Roodepoort 1709, South Africa; (J.C.); (C.M.); (M.K.); (J.J.); (I.P.); (M.V.)
| | - Thandeka Moyo-Gwete
- National Institute for Communicable Diseases of the National Health Laboratory Services, Johannesburg 2192, South Africa; (T.M.-G.); (P.L.M.)
- MRC Antibody Immunity Research Unit, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2000, South Africa
| | - Penny L. Moore
- National Institute for Communicable Diseases of the National Health Laboratory Services, Johannesburg 2192, South Africa; (T.M.-G.); (P.L.M.)
- MRC Antibody Immunity Research Unit, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2000, South Africa
| | - Munzhedzi Kutama
- Operations Division, South African National Blood Service, Roodepoort 1709, South Africa; (J.C.); (C.M.); (M.K.); (J.J.); (I.P.); (M.V.)
| | - Jabulisile Jaza
- Operations Division, South African National Blood Service, Roodepoort 1709, South Africa; (J.C.); (C.M.); (M.K.); (J.J.); (I.P.); (M.V.)
| | - Itumeleng Phayane
- Operations Division, South African National Blood Service, Roodepoort 1709, South Africa; (J.C.); (C.M.); (M.K.); (J.J.); (I.P.); (M.V.)
| | - Tinus Brits
- Information Technology Division, South African National Blood Service, Roodepoort 1709, South Africa; (T.B.); (J.K.)
| | - Johan Koekemoer
- Information Technology Division, South African National Blood Service, Roodepoort 1709, South Africa; (T.B.); (J.K.)
| | - Ute Jentsch
- Medical Division, South African National Blood Service, Roodepoort 1709, South Africa; (C.N.); (A.S.); (R.S.); (U.J.); (D.N.); (K.v.d.B.)
| | - Derrick Nelson
- Medical Division, South African National Blood Service, Roodepoort 1709, South Africa; (C.N.); (A.S.); (R.S.); (U.J.); (D.N.); (K.v.d.B.)
| | - Karin van den Berg
- Medical Division, South African National Blood Service, Roodepoort 1709, South Africa; (C.N.); (A.S.); (R.S.); (U.J.); (D.N.); (K.v.d.B.)
- Division of Clinical Haematology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town 7935, South Africa
- Division of Clinical Haematology, University of the Free State, Bloemfontein 9301, South Africa
| | - Marion Vermeulen
- Operations Division, South African National Blood Service, Roodepoort 1709, South Africa; (J.C.); (C.M.); (M.K.); (J.J.); (I.P.); (M.V.)
- Division of Clinical Haematology, University of the Free State, Bloemfontein 9301, South Africa
| |
Collapse
|