Introduction: Antibody-mediated transfusion-related acute lung injury (TRALI) is caused by antibodies against human leukocyte antigens (HLAs) or human neutrophil antigens (HNAs), and is one of the most serious complications associated with transfusion medicine Prevention strategies like testing allo-exposed female blood donors have not yet been introduced nationwide in Austria To assess the need and feasibility of routine leukocyte antibody testing, the prevalence of leukocyte-reactive antibodies in an Austrian female donor population was been determined using classical cell-based methods which were compared with a high-throughput bead-based method Methods: Sera from 1,022 female blood donors were screened using a granulocyte aggregation test (GAT) and a white blood cell immunofluorescence test (WIFT) after retesting and specification of positive samples by granulocyte immunofluorescence test (GIFT) and monoclonal antibody-specific immobilization of granulocyte antigens (MAIGA) Potential HLA reactivities were confirmed using the microbeads assay LabScreenTM Mixed The results in 142 donor sera and 38 well-defined reference sera were investigated by the microbeads assay LabScreenTM Multi and compared with classical cell-based methods Results: Reactivity with either granulocytes and/or lymphocytes was detected in 79 sera (7 7%), with the majority being HLA-specific Antibodies against HNA were obtained in 7 samples (0 7%) The aggregating potential of the detected antibodies was observed in 9 cases (0 9%) Most of the leukocyte-reactive antibodies occurred at a donor age of between 35 and 59 years (n = 61) LabScreen Multi showed good agreement (κ = 0 767) for HNA antibody detection by cell-based assays, but double/multiple specificities (100% of 7 anti-HNA-1b sera) as well as false-negative results (40% of 15 HNA-3-specific sera) occurred Discussion: Leukocyte-reactive antibody screening is advised in Austrian female donors for safe blood transfusion, including single-donor convalescent plasma treatment of COVID-19 that may be implemented soon For the introduction of LabScreen Multi, the combination with GAT should be considered to ensure correct anti-HNA-3a detection

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女性献血者的白细胞反应性抗体：奥地利的经验

简介：抗体介导的输血相关性急性肺损伤（TRALI）是由针对人类白细胞抗原（HLA）或人类中性粒细胞抗原（HNA）的抗体引起的，是与输血药物相关的最严重的并发症之一。 - 奥地利尚未在全国范围内引入暴露的女性献血者 为了评估常规白细胞抗体检测的必要性和可行性，使用经典的基于细胞的方法确定了奥地利女性献血者人群中白细胞反应性抗体的流行率，并进行了比较使用基于珠子的高通量方法方法：来自 1 的血清，022 名女性献血者在通过粒细胞免疫荧光试验 (GIFT) 和单克隆抗体特异性粒细胞抗原固定化 (MAIGA) 重新检测和指定阳性样本后，使用粒细胞聚集试验 (GAT) 和白细胞免疫荧光试验 (WIFT) 筛选使用微珠试验 LabScreenTM Mixed 确认了潜在的 HLA 反应性 通过微珠试验 LabScreenTM Multi 研究了 142 份供体血清和 38 份明确参考血清的结果，并与经典的基于细胞的方法进行比较 结果：与粒细胞和/或淋巴细胞的反应性在 79 份血清中检测到（7 7%），其中大多数是 HLA 特异性抗体 在 7 个样本中获得了针对 HNA 的抗体 (0 7%) 在 9 例 (0 9%) 中观察到检测到的抗体的聚集潜力 大多数白细胞反应性抗体发生在供体年龄35 至 59 岁之间 (n = 61) LabScreen Multi 显示出通过基于细胞的测定法检测 HNA 抗体的良好一致性 (κ = 0 767)，但也具有双重/多重特异性（100% 的 7 种抗 HNA-1b 血清）出现假阴性结果（15 份 HNA-3 特异性血清的 40%） 讨论：建议在奥地利女性献血者中进行白细胞反应性抗体筛查，以确保安全输血，包括对 COVID-19 的单一献血者进行恢复期血浆治疗即将实施 对于 LabScreen Multi 的引入，应考虑与 GAT 结合以确保正确检测抗 HNA-3a应考虑与 GAT 结合以确保正确检测抗 HNA-3a应考虑与 GAT 结合以确保正确检测抗 HNA-3a应考虑与 GAT 结合以确保正确检测抗 HNA-3a应考虑与 GAT 结合以确保正确检测抗 HNA-3a但出现双重/多重特异性（7 个抗 HNA-1b 血清的 100%）以及假阴性结果（15 个 HNA-3 特异性血清的 40%） 讨论：建议在奥地利女性供体中进行白细胞反应性抗体筛查用于安全输血，包括可能很快实施的 COVID-19 的单供体恢复期血浆治疗 对于 LabScreen Multi 的引入，应考虑与 GAT 组合以确保正确的抗 HNA-3a 检测但出现双重/多重特异性（7 个抗 HNA-1b 血清的 100%）以及假阴性结果（15 个 HNA-3 特异性血清的 40%） 讨论：建议在奥地利女性供体中进行白细胞反应性抗体筛查用于安全输血，包括可能很快实施的 COVID-19 的单供体恢复期血浆治疗 对于 LabScreen Multi 的引入，应考虑与 GAT 组合以确保正确的抗 HNA-3a 检测应考虑与 GAT 结合以确保正确检测抗 HNA-3a应考虑与 GAT 结合以确保正确检测抗 HNA-3a