Transfusion-related acute lung injury (TRALI) is a major complication posttransfusion. A consensus definition of TRALI has been recently established to improve diagnosis but the pathogenesis of TRALI is yet to be understood. Although the antibody-mediated two-hit model of TRALI is the classical narrative, increasing evidence of the probable implications of prolonged storage of blood provides novel mechanisms towards storage lesion-the potentially injurious cellular and biochemical changes that occur in stored red blood cells. Red blood cell-derived lipids and micro vesicles may have been playing an important role in the development of TRALI. This article will provide a brief overview of the current understanding of TRALI and then discuss the implications and the potential mechanisms by which stored red blood cells may lead to TRALI. TRALI is characterized by clinical features that include, but not limited to, dyspnea, tachypnea, respiratory insufficiency, noncardiogenic bilateral pulmonary edema, decreased pulmonary compliance and acute hypoxemia (PaO 2 /FiO 2 <300 mmHg, (Table 1) [13,14]. KeywordsThe incidence of TRALI ranges from 1/5,000-1/1,323 transfusions within the general population and it is the leading cause of transfusion-related death in the United States [15]. Such large range in incidence could be attributed to the relatively unspecific diagnostics tools available for TRALI, past cases of under-diagnosis or misdiagnosis, and the elevated incidence of TRALI within vulnerable populations [14][15][16]. A recent study analyzing the incidence of TRALI in critically ill patients admitted to intensive care unit (ICU) observed that over 5% of all patients who received blood transfusion developed TRALI, which is 50-100 times greater occurrence than in the general hospital population [12,17]. Risk factors related to recipients and donorsThe risk factors of TRALI are highly diverse, among patients DefinitionDiagnostic Parameters TRALIBi-lateral infiltrates with non-cardiogenic pulmonary edema. ARDS appearance within 6hours after transfusion. Hypoxemia: PaO 2 /F i O 2 < 300 mmHg. Potential TRALI Similar to TRALI diagnosis with an additional risk-factor for lung injury/ARDS. Delayed TRALI Diagnostic parameters characteristic of TRALI within 24-72 hours after transfusion.

Нижегородский госуниверситет им. Н.И. Лобачевского, *Нижегородский НИИ травматологии и ортопедии, г. Нижний Новгород Резюме. Обнаружено снижение относительного содержания CD50 + мононуклеарных клеток и повышение сывороточного уровня растворимой формы CD50 антигена в крови ожоговых больных с разной площадью поражения кожного покрова. Выявленные изменения могут оказывать влияние на формирование иммунодефицита, возникающего на фоне ожоговой травмы.