LAUSR

I n the past three decades, there has been much progress in the understanding of the antibodies associated with transfusion-related acute lung injury (TRALI) in humans. Implementation of strategies that reduce leukocyte antibodies in donor plasma reduced the incidence of TRALI according to meta-analyses and several reports and attest to the important role of leukocyte antibodies. Here, we describe evidence that HNA and HLA class II antibodies are the clinically relevant antibodies for the development of TRALI, while HLA class I antibodies play a minor role. We also discuss the differences in each of these antibodies that may explain the observed differences in clinical relevance. This is a commentary on clinical relevance, and is not a comprehensive review of pathophysiology.