A retrospective observational study to estimate the risk of HLA alloimmunization with blood transfusion: Can the risk be reduced by leucodepletion?

Immunobiology. 2023 Sep;228(5):152727. doi: 10.1016/j.imbio.2023.152727. Epub 2023 Aug 9.

Abstract

Background: In this retrospective study, our aim was to find the effect of leucodepleted (LD) blood transfusions on the formation of anti-HLA-antibodies when compared to non-leucodepleted (non-LD) transfusions using Luminex-based method.

Methods: In this study, Luminex single antigen bead assay (L-SAB) and HLA typing were performed on 310 patients. Test positivity rates (as MFI - Mean florescence intensity) were analyzed according to the different sensitization events and gender.

Results: Of the 310 patients included in the study, 58.06% (180) patients were male and 41.93% (130) were female. The average age of the patients was 42.86 (±12.37) years. In this study, test positivity rates were significantly lower in the patients who received LD RBC units than in those who received non-LD RBC units (28.43% = 29 of 102 Vs 55.22% = 74 of 134, p < 0.05). In our study, transfusion combined with a history of pregnancy had higher number of significant HLA antibodies compared to cases where transfusion was the only sensitization event (81.81% = 18/22 Vs 39.71% = 85/214, p < 0.05). In addition, anti-HLA-antibodies-MFI were significantly (p < 0.01) higher in non-LD patients compared to LD patients.

Conclusion: Patients who received LD RBC units had a significantly lower rate of transfusion-associated alloimmunization compared to those who received non-LD RBC units. Multiparous women had a high risk for transfusion-related alloimmunization compared to both nulliparous women and male patient. Furthermore, class I-anti-HLA-antibodies (HLA-B and HLA-A + B) were significantly associated with pregnancy sensitization and/or blood transfusion as a single sensitization.

Keywords: Donor-specific antibodies; HLA; HLA-antibodies; Kidney transplantation; Mean fluorescence intensity; SAB assay; Solid-phase assay.

Publication types

  • Observational Study

MeSH terms

  • Blood Transfusion* / methods
  • Female
  • HLA Antigens* / metabolism
  • Humans
  • Isoantibodies / metabolism
  • Leukocytes
  • Male
  • Retrospective Studies
  • Transfusion Reaction*

Substances

  • HLA Antigens
  • Isoantibodies