Risk Factors for Transfusion-Related Acute Lung Injury

Hu, Lunyang; Wang, Baoli; Jiang, Yong; Zhu, Baorang; Wang, Chen; Yu, Qing; Hou, Wenjia; Xia, Zhaofan; Wu, Guosheng; Sun, Yu

doi:10.4187/respcare.08829

Cited by 8 publications

(9 citation statements)

References 47 publications

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“…At present, epidemiological data on TRALI are mainly obtained through active reporting by medical institutions, and fewer clinical case reports and basic studies are available, probably due to the lack of awareness of this adverse reaction among front-line clinical physicians and unstandardized diagnostic criteria, resulting in a relatively excessive rate of clinical misdiagnosis or underdiagnosis [ 3 , 4 ]. TRALI is fast-onset, difficult to identify, and some patients are at a higher risk of developing TRALI, and it has been previously reported that critical patients are at a higher risk of developing TRALI, so timely detection and effective management in the clinic is important to improve their prognosis, and understanding the factors affecting TRALI can provide important guidance for its clinical management [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Clinical Factors of Blood Transfusion-Related Acute Lung Injury and Changes in Levels of Treg-Related Cytokines

Sun

Liu

2022

Emergency Medicine International

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Objective. Analysis of clinical factors and changes in regulatory T cell (Treg)-related cytokine levels in transfusion-associated acute lung injury (TRALI). Methods. 62 patients who underwent blood transfusion and developed TRALI (TRALI group) in our hospital between January 2018 and December 2021 and 58 patients who did not develop TRALI (non-TRALI group) from blood transfusion were selected to collect clinical data from patients and construct a logistic regression model to analyze clinical risk factors for TRALI. Based on the prognosis of TRALI patients, they were divided into survival group (50 cases) and death group (12 cases), and serum CD4 + CD25 + Treg and Treg-related cytokines (interleukin 10 (IL-10), transforming growth factor-β (TGF-β)) levels were compared between the two groups, and the correlation between CD4 + CD25 + Treg and IL-10 and TGF-β was analyzed by Pearson. Results. The differences in smoking history, human leukocyte antigen (HLA) antibody II, pretransfusion shock, and CD4 + CD25 + Treg between the TRALI group and non-TRALI group were statistically significant ( P < 0.05 ). Logistic regression analysis showed that HLA antibody II and increased CD4 + CD25 + Treg were independent risk factors of TRALI ( P < 0.05 ). The levels of CD4 + CD25 + Treg, IL-10, and TGF-β in the death group were significantly higher than those in the survival group ( P < 0.05 ). CD4 + CD25 + Treg was positively correlated with levels of IL-10 and TGF-β ( P < 0.05 ). Conclusion. Elevated HLA antibody II and CD4 + CD25 + Treg are the main clinical risk factors for TRALI, and CD4 + CD25 + Treg may be involved in immunosuppression by increasing the expression levels of IL-10 and TGF-β. Early clinical monitoring of changes in Treg-related cytokine levels can provide some guidance for prognostic assessment of TRALI patients.

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Section: Introductionmentioning

confidence: 99%

Clinical Factors of Blood Transfusion-Related Acute Lung Injury and Changes in Levels of Treg-Related Cytokines

Sun

Liu

2022

Emergency Medicine International

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“…One major risk factor includes the number of transfusions an individual receives. Moreover, the number of units of fresh frozen plasma for transfusion also increases the risk of TRALI [ 16 ]. Other potential risk factors may include female sex, age, chronic alcohol abuse, and tobacco use, among others.…”

Section: Reviewmentioning

confidence: 99%

“…Other potential risk factors may include female sex, age, chronic alcohol abuse, and tobacco use, among others. Host-related risk factors are believed to play a large role as opposed to blood transfusion factors [ 16 ]. Importantly, patients with SCD are at an increased risk of red blood cell alloimmunization, which significantly contributes to the onset of TRALI [ 5 ].…”

Section: Reviewmentioning

confidence: 99%

“…Women who have been previously pregnant are automatically disqualified from donation [ 10 ]. Some facilities within the United States have also excluded the use of fresh frozen plasma from female donors due to the heightened risk of TRALI development [ 16 ]. Regardless of these protocols, it is important to be consistent at a national level to ensure that standardized practices can be obtained.…”

Section: Reviewmentioning

confidence: 99%

“…Table 3 provides a summary of the characteristics of the final included studies for this review article [ 4 , 8 - 12 , 14 - 16 ].…”

Section: Introductionmentioning

confidence: 99%

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A Systematic Review on the Management of Transfusion-Related Acute Lung Injury in Transfusion-Dependent Sickle Cell Disease

Arzoun¹,

Srinivasan²,

Adam³

et al. 2022

Cureus

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The onset of respiratory distress and acute lung injury (ALI) following a blood transfusion is known as transfusion-related acute lung injury (TRALI), although its pathophysiology remains unknown. Even though sickle cell disease (SCD) has been studied for more than a century, few therapeutic and management strategies adequately address the emergence of TRALI. TRALI, an immune-mediated transfusion response that can result in life-threatening consequences, is diagnosed based on clinical signs and symptoms. Early detection and treatment increase the chances of survival and, in most cases, result in a complete recovery. Our objective is to provide a firm grasp of the present status of SCD-related TRALI care and therapy. After exploring multiple databases, this study offers evidence-based guidelines to aid clinicians and other healthcare professionals make decisions concerning transfusion assistance for SCD and the management of transfusion-related complications. Other risk factors for acute lung injury including sepsis aspiration should be ruled out throughout the diagnostic process. Several recent studies have shown that immunotherapy or immunological targets can effectively prevent these complications. Red cell transfusions, red cell antigen matching optimization, and iron chelation can also help reduce negative consequences. It is to be noted that poor clinical outcomes can be avoided by early detection and treatment of hemolytic transfusion reactions. Finally, preventing the onset of TRALI may be the most effective therapeutic strategy for SCD patients who rely on blood transfusions for survival.

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Palmatine alleviates LPS-induced acute lung injury via interfering the interaction of TAK1 and TAB1

Song

et al. 2022

Biochemical Pharmacology

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Risk Factors for Transfusion-Related Acute Lung Injury

Cited by 8 publications

References 47 publications

Clinical Factors of Blood Transfusion-Related Acute Lung Injury and Changes in Levels of Treg-Related Cytokines

Clinical Factors of Blood Transfusion-Related Acute Lung Injury and Changes in Levels of Treg-Related Cytokines

A Systematic Review on the Management of Transfusion-Related Acute Lung Injury in Transfusion-Dependent Sickle Cell Disease

Palmatine alleviates LPS-induced acute lung injury via interfering the interaction of TAK1 and TAB1

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