Transfusion-related acute lung injury: incidence and risk factors

Toy, Pearl; Gajic, Ognjen; Bacchetti, Peter; Looney, Mark R.; Gropper, Michael A.; Hubmayr, Rolf D.; Lowell, Clifford A.; Norris, Philip J.; Murphy, Edward L.; Weiskopf, Richard B.; Wilson, Gregory; Koenigsberg, Monique; Lee, Deanna; Schuller, Randy M.; Wu, Ping; Grimes, Barbara; Gandhi, Manish J.; Winters, Jeffrey L.; Mair, David; Hirschler, Nora V.; Rosen, Rosa Sanchez; Matthay, Michael A.

doi:10.1182/blood-2011-08-370932

Cited by 483 publications

(588 citation statements)

References 46 publications

Supporting

Mentioning

556

Contrasting

Unclassified

Order By: Relevance

“…[38][39][40] TRALI secondary to RBC infusion results in a number of reported fatalities, and that number has likely increased with antibody-negative plasma transfusion strategies. [1][2][3][4]41,42 Moreover, removal of the lipophilic compounds may also diminish the clinical effects of stored RBCs especially in the critically ill and in the injured. Although never associated with RBC storage age, TRALI did significantly correlate with PC age and, more importantly, with the amount of proinflammatory lipid priming activity present in the implicated PCs.…”

Section: Discussionmentioning

confidence: 99%

Experimental prestorage filtration removes antibodies and decreases lipids in RBC supernatants mitigating TRALI in vivo

Silliman

Kelher

Khan³

et al. 2014

Blood

View full text Add to dashboard Cite

Key Points• TRALI may be induced by antibodies to HLA or HNA antigens or lipids, which accumulate during storage.• Prestorage experimental filtration of RBCs removes HLA and HNA antibodies, decreases lipid priming activity, and mitigates TRALI in an animal model.Transfusion-related acute lung injury (TRALI) remains a significant cause of transfusionrelated mortality with red cell transfusion. We hypothesize that prestorage filtration may reduce proinflammatory activity in the red blood cell (RBC) supernatant and prevent TRALI. Filters were manufactured for both small volumes and RBC units. Plasma containing antibodies to human lymphocyte antigen (HLA)-A2 or human neutrophil antigen (HNA)-3a was filtered, and immunoglobulins and specific HNA-3a and HLA-2a neutrophil (PMN) priming activity were measured. Antibodies to OX27 were added to plasma, and filtration was evaluated in a 2-event animal model of TRALI. RBC units from 31 donors known to have antibodies against HLA antigens and from 16 antibody-negative controls were filtered. Furthermore, 4 RBC units were drawn and underwent standard leukoreduction. Immunoglobulins, HLA antibodies, PMN priming activity, and the ability to induce TRALI in an animal model were measured. Small-volume filtration of plasma removed >96% of IgG, antibodies to HLA-A2 and HNA-3a, and their respective priming activity, as well as mitigating antibodymediated in vivo TRALI. In RBC units, experimental filtration removed antibodies to HLA antigens and inhibited the accumulation of lipid priming activity and lipid-mediated TRALI. We conclude that filtration removes proinflammatory activity and the ability to induce TRALI from RBCs and may represent a TRALI mitigation step. (Blood. 2014;123(22):3488-3495)

show abstract

Section: Discussionmentioning

confidence: 99%

Experimental prestorage filtration removes antibodies and decreases lipids in RBC supernatants mitigating TRALI in vivo

Silliman

Kelher

Khan³

et al. 2014

Blood

View full text Add to dashboard Cite

show abstract

“…1 This study provides important new insights into our mechanistic understanding of an important clinical problem in transfusion medicine and validates the effectiveness of TRALI mitigating strategies that have been implemented.…”

mentioning

confidence: 62%

Giving TRALI the one-two punch

Shaz

2012

Blood

View full text Add to dashboard Cite

“…The risk of TRALI is reduced from 2.57 per 10,000 transfusion units in 2006 to 0.81 in 2009 due to reduced use of blood products. 1,3 The most common setting of TRALI in children was induction chemotherapy for acute lymphoblastic leukemia (ALL). In published series of TRALI, plasma-containing blood components are most commonly implicated with maximum risk in whole bloodederived platelet concentrates (WB-PLTs), followed by FFP, PRBCs, whole blood, aphaeresis platelet concentrates (A-PLTs) granulocytes, cryoprecipitate and intravenous immunoglobulin (IVIG).…”

Section: Discussionmentioning

confidence: 99%

“…However incidence of TRALI in a case of thalassemia is not known. 1 We report a case of TRALI in 11-year-old girl with Eb thalassemia.…”

Section: Introductionmentioning

confidence: 92%