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A randomized controlled trial of transfusion-related acute lung injury: Is plasma from multiparous blood donors dangerous?
Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Transfusion Medicine. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Immunology and Transfusion Medicine.
Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Anaesthesiology. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Clinical Immunology. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Immunology and Transfusion Medicine.
Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Transfusion Medicine. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Immunology and Transfusion Medicine.
2001 (English)In: Transfusion, ISSN 0041-1132, E-ISSN 1537-2995, Vol. 41, no 3, 317-322 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Transfusion-related acute lung injury (TRALI) and other posttransfusion reactions may be caused by granulocyte and/or HLA antibodies, which are often present in blood from multiparous donors. The purpose of this study was to compare the effects of plasma from multiparous donors with those of plasma from donors with no history of transfusion or pregnancy (control plasma) in a prospective, randomized, double-blind, crossover study. STUDY DESIGN AND METHODS: Intensive care patients, judged to need at least 2 units of plasma, were randomly assigned to receive a unit of control plasma and, 4 hours later, a plasma unit from a multiparous donor (=3 live births) or to receive the plasma units in opposite order. The patients were closely monitored, and body temperature, blood pressure, and heart rate were recorded. Blood samples for analysis of blood gases, TNFa, IL-1 receptor antagonist, soluble E selectin, and C3d complement factor were collected at least on four occasions (before and after the transfusion of each unit). RESULTS: Transfusion of plasma from multiparous donors was associated with significantly lower oxygen saturation and higher TNFa concentrations than transfusion of control plasma. The mean arterial pressure increased significantly after the transfusion of control plasma, whereas plasma from multiparous donors had no effect on it. Five posttransfusion reactions were observed in 100 patients, in four cases after the transfusion of plasma from multiparous donors. CONCLUSION: Plasma from multiparous blood donors may impair pulmonary function in intensive care unit patients.

Place, publisher, year, edition, pages
2001. Vol. 41, no 3, 317-322 p.
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Medical and Health Sciences
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URN: urn:nbn:se:liu:diva-25800DOI: 10.1046/j.1537-2995.2001.41030317.xLocal ID: 10237OAI: oai:DiVA.org:liu-25800DiVA: diva2:246348
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13

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Palfi, MiodragBerg, SörenErnerudh, JanBerlin, Gösta

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Faculty of Health SciencesTransfusion MedicineDepartment of Clinical Immunology and Transfusion MedicineAnaesthesiologyDepartment of Thoracic and Vascular SurgeryClinical Immunology
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