
Mitigate TRALI risk with simultaneous detection of HLA and HNA antibodies in a single well
Convalescent plasma therapy’s potential role in COVID-19
The rise of the severe acute respiratory syndrome coronavirus 2 (SARS–CoV-2), the cause of coronavirus disease 2019 (COVID-19), has spurred a global health crisis. Although many treatments are in rapid development, to date there are no drugs, vaccines, or options for prophylaxis. Human convalescent plasma has been shown to have a positive impact on COVID-19 patients and could become available when a sufficient number of people have recovered and can donate blood containing neutralizing antibodies1.
Research indicates convalescent plasma therapy may help fight viral infections
Collected from patients who have recovered from COVID-19, convalescent plasma contains SARS-Cov-2 specific neutralizing antibodies. Passive antibody administration through transfusion of convalescent plasma may be the only short-term strategy for providing immediate immunity to susceptible individuals2. This treatment has been studied in outbreaks of numerous respiratory infections3 including the 2003 SARS-Cov-1 epidemic4, 2009 H1N1 influenza pandemic5, and 2012 MERS-Cov epidemic6. These studies as well as recent data on SARS-Cov-27, 8, 9 suggest that convalescent plasma therapies have the potential to reduce the severity or shorten the length of illness caused by COVID-19.
TRALI is a significant barrier to the potential of convalescent plasma therapy for COVID-19
Transfusion-related acute lung injury (TRALI) is a serious pulmonary syndrome that, if not recognized and treated, can lead to death10. Patients who receive plasma-containing products may be at risk for TRALI; it is consistently a leading cause of transfusion-related mortality11 and has been found to be fatal in 5-10% of all cases12. COVID-19 patients with acute respiratory distress syndrome (ARDS), or who may progress to ARDS, may have a higher risk of TRALI due to their underlying lung injury13.
Donor anti-HLA and anti-HNA antibodies are associated with TRALI
The cause of TRALI may be attributed to either anti-HLA or anti-HNA antibodies considering that 89% of cases involve donors who have one or both antibody types present14. Reports show that antibodies directed against HNA 1a, 1b and 2a are associated with severe forms of TRALI15. Anti-HNA-3a is believed to cause significant morbidity and is most often associated with fatal TRALI16.
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