Spotlight on pathogenesis of TRALI: HNA-3a (CTL2) antibodies.

Journal Article (Journal Article;Review)

Human neutrophil antigen-3a (HNA-3a) antibodies contained in donor plasma can result in severe, sometimes fatal transfusion-related acute lung injury (TRALI). Recent developments in TRALI secondary to antibodies to HNA-3a antigen span diagnosis, pathophysiology, treatment, and prevention resulting in improved understanding, potential treatments, and mitigation strategies. First, on the molecular level, characterization of HNA-3 antigen has allowed for genotyping methods that clarify population prevalence. Related work has led to generation of multiple antibody detection assays. These assays aid in determining potential populations at risk and potential mitigation strategies. Second, the development of TRALI requires a hit from the patient and from the product. Anti- HNA-3a is one of the product-derived factors and appears to result in TRALI by binding directly to pulmonary endothelium as well as to neutrophils expressing the corresponding antigen. Finally, potential mitigation strategies include red blood cell product filtration to remove anti-HNA-3a as well as other antibodies.

Full Text

Duke Authors

Cited Authors

  • Storch, EK; Hillyer, CD; Shaz, BH

Published Date

  • September 18, 2014

Published In

Volume / Issue

  • 124 / 12

Start / End Page

  • 1868 - 1872

PubMed ID

  • 25006121

Electronic International Standard Serial Number (EISSN)

  • 1528-0020

Digital Object Identifier (DOI)

  • 10.1182/blood-2014-05-538181


  • eng

Conference Location

  • United States