Korean J Blood Transfus.  2015 Aug;26(2):174-184. 10.17945/kjbt.2015.26.2.174.

Human Neutrophil Alloantigen-3a Alloimmunization among Pregnant Korean Women

• Han TH
• Han KS

• KMID: 2255813
• DOI: http://doi.org/10.17945/kjbt.2015.26.2.174

Abstract

BACKGROUND
Alloantibodies against human neutrophil alloantigen (HNA)-3a are associated with severe and fatal transfusion related acute lung injury (TRALI). HNA-3 genotyping and HNA-3a antibody (Ab) identification are essential to diagnosis and prevention of TRALI caused by HNA-3a Ab. However there had been no laboratory for HNA-3a Ab identification in Korea. The aims of this study were to establish the HNA-3a Ab test in Korea and to estimate the incidence of HNA-3a alloimmunization among pregnant Korean women.
METHODS
HNA-3a homozygotes and HNA-3b homozygotes were identified by HNA-3 genotyping. Three HNA-3a homozygotes and three HNA-3b homozygotes are included in the granulocytes panel, which consisted of 10 donors for granulocytes. Sera from 650 pregnant Korean women were tested for granulocyte Ab using a mixed passive hemagglutination assay (MPHA). When a HNA-3a Ab was detected, the woman's HNA-3 was typed to support her HNA-3a alloimmunization.
RESULTS
MPHA showed positive reactions in the sera from 26 women (4.0%, 26/650). HLA Abs were detected in 18 women (2.8%, 18/650), among whom HNA Abs were identified simultaneously in 7 women. Granulocyte Abs were detected in sera from 15 women (2.3%, 15/650). The incidence of HNA-3a, HNA-1b, HNA-1a, HNA-2a, and unidentified HNA Abs among pregnant Korean women was 0.77% (5/650), 0.77% (5/650), 0.62% (4/650), 0.15 (1/650), and 0.31% (2/650), respectively.
CONCLUSION
In this study, we established the HNA-3a Ab test using MPHA for diagnosis and prevention of TRALI caused by HNA-3a Ab. The incidence of HNA-3a Ab in pregnant Korean women was 0.77% (5/650).

Keyword

HNA-3a antigen (HNA-3a) antibody; Alloimmunization; Transfusion related acute lung injury (TRALI); Mixed passive hemagglutination assay (MPHA)

MeSH Terms

Acute Lung Injury
Diagnosis
Female
Granulocytes
Hemagglutination
Homozygote
Humans*
Incidence
Isoantibodies
Isoantigens
Korea
Neutrophils*
Tissue Donors
Isoantibodies
Isoantigens