Q. Since Canadian Blood Services (CBS) began using “male” only plasma is TRALI still considered a risk of plasma or platelet transfusions?

A. The use of “male only” plasma for frozen plasma and platelet preparations is expected to reduce substantially the frequency of TRALI; this has been the experience in other jurisdictions. The rationale is to remove from the supply plasma from women who may have been immunized in pregnancy against HLA and other leucocyte-borne antigens. However, this measure will not alone eliminate TRALI, as a proportion of cases involve a different, ill-understood, mechanism. Furthermore, it is unlikely that female donors can be removed from the red cell donor pool, and since TRALI is also mediated by the plasma in the red cell units, a small number of cases mediated by female plasma will likely remain. For further information and references see the recent review by Vamvakas and Blajchman, published on-line on 4/02/09 at www.bloodjournal.org.

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