BOF: Transfusion (Histocompatibility)

Which one of the following syndromes is NOT thought to frequently be a direct consequence of Human Leucocyte Antigen system incompatibility?

a) Graft versus host disease

b) Haemolytic disease of the newborn

c) Immune-mediated platelet transfusion refractoriness.

d) Non-haemolytic febrile transfusion reaction (NHFTR)

e) Transfusion-related acute lung injury (TRALI)

Answer:

b) Haemolytic disease of the newborn

Explanation:

Haemolytic disease of the newborn is most frequently due to maternal alloantibodies directed against paternally derived fetal red cell antigens due to sensitisation usually during that pregnancy or prior pregnancies. The other pathologies are thought to arise from HLA directed antibody or cell mediated toxicity.

Reference:

Shaz, B. H., Stowell, S. R., & Hillyer, C. D. (2011). Transfusion-related acute lung injury: from bedside to bench and back. Blood,117(5), 1463-1471.