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.

IF 2.5 3区医学 Q2 HEMATOLOGY

Transfusion Pub Date : 2024-07-23 DOI:10.1111/trf.17962

Katarzyna Guz, Patrycja Łopacz, Małgorzata Uhrynowska, Karolina Piaskowska, Beata Szczepaniak, Magdalena Krzemienowska, Sylwia Purchla-Szepioła, Anna Główka, Eliza Głodkowska-Mrówka, Agnieszka Orzińska

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引用次数: 0

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.

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对暴露于异体的 COVID-19 康复血浆捐献者进行抗 HNA 检测，包括基因人类中性粒细胞抗原筛查，以预防抗 HNA 抗体介导的输血相关急性肺损伤。

背景：由人类中性粒细胞抗原（HNA）抗体引起的输血相关急性肺损伤是一种严重但罕见的输血并发症。有输血/妊娠史的献血者最有可能出现这种抗体。在 COVID-19 大流行期间，含有 SARS-CoV-2 中和抗体的康复血浆（CP）被广泛用于 COVID-19 患者的治疗。本研究的目的是制定一种简单的诊断算法，对异体暴露的 CP 供体进行抗 HNA 检测，包括基因 HNA 筛查：共对 457 名抗-HLA 阴性的同种异体暴露 CP 供体进行了 HNA-1a/1b、HNA-3a/3b 和 HNA-2 基因分型；使用 LabScreenMulti（One Lambda）检测抗 HNA 抗体，使用粒细胞免疫荧光试验（GIFT）检测同型 HNA-1b/1b，但使用 LabScreenMulti 进行验证。结果对 83 例同源 HNA-3b/3b、HNA-2null 或 HNA-1a/1a 供体进行检测后发现，其中一例存在抗 HNA-3a 抗体。使用 GIFT 对 181 名 HNA-1b/1b 供体进行检测，得出了 10 个不明确的结果，使用 LabScreenMulti 进行了验证，在一个病例中确认了抗 HNA-1a 抗体。编码 HNA-1a 的 FCGR3B*01 和 *04 的频率为 0.34；编码 HNA-1b 的 FCGR3B*02、*03 和 *05 的频率为 0.66；编码 HNA-3a 的 SLC44A2*01 的频率为 0.80；编码 HNA-3b 的 SLC44A2*02 的频率为 0.20。在 3.7% 的病例中发现了 HNA-2null 基因型：讨论：由于将 HNA 基因分型作为抗 HNA 抗体检测前的主要检测方法，因此血清学工作仅限于 HNA 同源供体，并揭示了两名抗 HNA 免疫供体。队列中 HNA 基因型的分布与其他高加索人群相似。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Transfusion 医学-血液学

CiteScore

4.70

自引率

20.70%

发文量

426

审稿时长

1 months

期刊介绍： TRANSFUSION is the foremost publication in the world for new information regarding transfusion medicine. Written by and for members of AABB and other health-care workers, TRANSFUSION reports on the latest technical advances, discusses opposing viewpoints regarding controversial issues, and presents key conference proceedings. In addition to blood banking and transfusion medicine topics, TRANSFUSION presents submissions concerning patient blood management, tissue transplantation and hematopoietic, cellular, and gene therapies.

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