Transfusion-related acute lung injury; clinical perspectives

Abstract

Transfusion-related acute lung injury (TRALI) was introduced in 1983 to describe a clinical syndrome seen within 6 h of a plasma-containing blood products transfusion. TRALI is a rare transfusion complication; however, the FDA has suggested that TRALI is the leading cause of transfusion-related mortality. Understanding the pathogenesis of TRALI will facilitate adopting preventive strategies, such as deferring high plasma volume female product donors. This review outlines the clinical features, pathogenesis, treatment, and prevention of TRALI.

Preventing murine transfusion‐related acute lung injury by expansion of CD4+CD25+FoxP3+ Tregs using IL‐2/anti‐IL‐2 complexes

“…We clearly demonstrated pulmonary polymorphonuclear neutrophil accumulation in our TRALI mouse model based on the increased MPO activity and lung histology (Fig. A and D); these pathologies have also been observed in the lungs of TRALI patients . For mice pretreated with IL‐2 or IL‐2c before model induction, acute granulocyte infiltration and MPO activity were reduced in the lung, which is one example of evidence that IL‐2 or IL‐2c administration can promote neutrophil clearance, restrict the infiltration of neutrophils and prevents lung inflammation.…”

Transfusion Related Acute Lung Injury after Iatrogenic Intrabdominal Bleeding: A Case Report

“…Antibodies to both human leukocyte antigens (HLA class I and II) and human neutrophil antigens (HNAs) are the key factors in the pathogenesis of immune mediated TRALI (10). The differential diagnosis of acute lung injury following transfusion includes transfusion-associated circulatory overload (TACO), cardiogenic edema, allergic and anaphylactic transfusion reactions, and bacteremia/sepsis due to transfusion of bacterially contaminated blood products (11). Of these, TACO and cardiogenic pulmonary edema are of particular importance, as both are frequently encountered in hospitalized patients and in those admitted to the ICU.…”

Noninvasive-Mechanical Ventilation Experience of Transfusion Related Acute Lung Injury (TRALI) after The Patient Undergoing Supracoronary Graft Interposition due to Ascending Aortic Aneurysm

“…Çalışılan kardiyak enzim ve fibrinojen değerleri, koagülasyon parametrelerinde bozulma olmaması olayın akut koroner sendrom veya pulmoner emboli açısından ayırıcı tanısında yardımcı oldu. TRALI kliniğininde hastaların 1/3'den azında ateş, hipotansiyon, siyanoz triadı görülmektedir [1] . Hastamızda postop 2. ve 3. günlerde birer kez ölçülen 37.2 ve 37.8°C ateşle beraber desatürasyon ve tedavi gerektirmeyen hipotansiyon gözlenmiştir.…”

“…Bu major komplikasyon, erken ve geç dönem reaksiyonu olarak ortaya çık-maktadır [1] . İlk TRALI olgusı 1950 yılında rapor edilmiştir [2] .…”