Transfusion-related acute lung injury (TRALI): a review of investigations by the National Tissue Typing Laboratory of cases reported in New Zealand since June 2004.

AIM: To review investigations of reported cases of Transfusion-Related Acute Lung Injury (TRALI) performed by the National Tissue Typing laboratory since 2004.

METHOD: Donors associated with reported cases of TRALI are recalled for white cell antibody tests. A donor is implicated if found to have neutrophil or HLA antibodies with specificity against one of the recipient's HLA antigens, or a positive white cell crossmatch. A retrospective review of investigations performed by the Tissue Typing Laboratory on TRALI cases from June 2004 to June 2007 was undertaken.

RESULTS: Seventeen cases of TRALI had tests performed by the Tissue Typing Laboratory over the 3-year period. A total of 67 donors were tested. Twenty-nine donors had a positive HLA-antibody screen and the majority of these were female (86%, with fresh frozen plasma (FFP) the commonest component type (41%). In 15 (88%) cases, HLA antibodies were found in donor sera and nine of these had specificity against patient HLA antigen or a positive crossmatch.

CONCLUSION: Preliminary data on TRALI investigations concur with overseas studies. Raising awareness of this hazard of transfusion and a consistent approach in investigation of TRALI will allow us to gain further insight into this complication in New Zealand and consequently explore strategies to prevent such adverse transfusion reactions.