New HLA Antibody Testing Policy for Female Platelet Donors

In April 2013, we began performing a Human Leukocyte Antigen (HLA) antibody test on each of our current platelet donors who has ever been pregnant. That’s a change from our previous testing of platelet donors with three or more pregnancies. In addition, we modified our Medical History Questionnaire to ask female donors whether they have been pregnant since their last donation. Platelet donors who respond yes will be screened for HLA antibodies. We will also retest platelet donors after any subsequent pregnancies. These adjustments reflect our ongoing efforts to minimize occurrences of Transfusion-Related Acute Lung Injury (TRALI).

TRALI is a rare but serious complication of blood transfusions most commonly thought to be caused by a reaction to white blood cell antibodies present in the donor’s plasma. When transfused, these antibodies can sometimes cause plasma to leak into the patient’s lungs, creating fluid accumulation — a condition referred to as acute pulmonary edema.

Female donors who have been pregnant and developed antibodies as a result of exposure to fetal blood are most likely to have these antibodies in their plasma. Once the antibodies develop, they are present in the blood forever. The antibodies are perfectly healthy for an individual to have in their blood, but could be harmful if transfused into certain patients. The antibodies are present in plasma — and platelet donations actually contain a high volume of plasma, so our current efforts are directed at adjusting the eligibility requirements for platelet donors.

We will notify donors of positive results by a phone call and a follow-up letter. If you test positive for these antibodies, you will not be eligible to donate platelets in the future, but we strongly encourage you to continue giving back to our community by donating whole blood or red cells instead, which are just as important to patients in need. And, as a whole blood donor, you will continue to build donor recognition points as you help people who need you.