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Pathology Immunity 18b726eb

TRALI usually is due to?

A
High titre anti-HLA antibodies in recipient plasma
B
low titre anti-HLA antibodies in donor plasma
C
High titre anti-HLA antibodies in donor plasma
D
HPA-la on the platelet glycoprotein Ilia receptor
High-Yield Explanation
Ans. is 'c' i.e. High titre anti-HLA antibodies in donor plasma Transfusion related acute lung injury (TRALI)* It is a serious blood transusion complication characterized by the acute onset of non-cardiogenic pulmonary edema following transfusion of blood products.* TRALI is defined as an acute lung injury that is temporally related to a blood transfusion; specifically, it occurs within the first six hours following a transfusion.* It is typically associated with plasma components such as platelets and fresh frozen plasma.* TRALI is thought to be immune mediated. Antibodies directed toward human leukocyte antigens (HLA) or human neutrophil antigens (HNA) have been implicated.* To be at risk of TRALI via this mechanism, the blood recipient must express the specific HLA or neutrophil receptors to which the implicated donor has formed antibodies. Previous transfusion or transplantation can also lead to donor sensitization.* Proposed clinical criteria for the diagnosis of TRALI include:1. Acute onset of pulmonary insufficiency (within 6 h)2. Hypoxemia, specifically pao 2 /fio 2 < 300 mm Hg3. Bilateral fluffy infiltrates on chest radiography4. Pulmonary artery wedge pressure < 18 mm Hg5. Absence of left atrial hypertension.

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