AABB survey of transfusion‐related acute lung injury policies and practices in the United States

Kopko, Patricia; Silva, Marianne Lucena da; Shulman, Ira A.; Kleinman, Steven

doi:10.1111/j.1537-2995.2007.01403.x

Cited by 24 publications

(19 citation statements)

References 9 publications

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“…An AABB survey of member institutions conducted in 2006 demonstrated the variability in practices at blood centers and hospitals, highlighting the disparate criteria used to initiate a TRALI investigation and the various donor management decisions in different clinical scenarios [14]. Many institutions reported used the Canadian Consensus Conference definition of TRALI, but often modified it, in ways that were not qualified in the survey.…”

Section: Current Blood Center Practices For Donor Deferralmentioning

confidence: 98%

“…Not surprisingly, blood centers and transfusion services have implemented different policies and procedures to address the standard [13][14][15]. An AABB survey of member institutions conducted in 2006 demonstrated the variability in practices at blood centers and hospitals, highlighting the disparate criteria used to initiate a TRALI investigation and the various donor management decisions in different clinical scenarios [14].…”

Section: Current Blood Center Practices For Donor Deferralmentioning

confidence: 99%

“…The efforts are largely focused on deferring blood donors implicated in TRALI and reducing patients' exposure to individual donor plasma and alloreactive leukocyte antibodies. These measures are predicated on the evidence that leukocyte alloantibodies trigger TRALI in susceptible patients [13][14][15].…”

Section: Introductionmentioning

confidence: 99%

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TRALI risk reduction: Donor and component management strategies

Eder

Benjamin

2009

J of Clinical Apheresis

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Transfusion-related lung injury (TRALI) occurs in approximately 1 in 5,000 transfusions and may cause considerably more morbidity and mortality that is not recognized in clinical practice. Based on the current understanding of the etiology of TRALI, blood centers have implemented or are evaluating various donor and component management strategies in an effort to mitigate the risk of TRALI. Many cases of TRALI are likely caused by antibodies to leukocyte antigens (HLA or HNA) in blood components. Approximately 10 to 20% of female blood donors with a history of pregnancy and 1 to 5% of male blood donors harbor these antibodies. Alternatively, TRALI may be mediated by other bioactive lipids or substances that accumulate during storage and cause a reaction when transfused to susceptible patients. The complex interplay among various donor-, component-, and patient-related factors underlying TRALI guarantees that effective prevention will not be a single or simple intervention but rather will require a multifaceted approach. Perhaps, the most important risk reduction strategy is the effort to ensure appropriate use of blood products and eliminate unnecessary transfusions. Blood collection agencies, however, have more proximate control over donor selection and component management than transfusion practice. AABB has provided some guidance on deferring donors implicated in TRALI and minimizing the preparation of high plasma volume components from donors who have anti-leukocyte antibodies or are at increased risk of leukocyte alloimmunization. Blood centers have taken various approaches to mitigate the risk of TRALI, and the possible benefit and the inherent limitations of the current strategies will be reviewed.

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Section: Current Blood Center Practices For Donor Deferralmentioning

confidence: 98%

Section: Current Blood Center Practices For Donor Deferralmentioning

confidence: 99%

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TRALI risk reduction: Donor and component management strategies

Eder

Benjamin

2009

J of Clinical Apheresis

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“…A pesar de las limitaciones metodológicas de este tipo de estudios, es un método que ayuda a dar un panorama general de la práctica clínica, por lo que ha sido utilizado con frecuencia en diferentes países con el objetivo específico de describir la utilización de hemoderivados en diferentes contextos clínicos; su empleo en las UCI ha sido escaso [8][9][10][11][12][13][14][15][16][17][18][19] .…”

Section: Introducción «Lo Que Sabemos Lo Sabemos Juntos» Hans Sigaarunclassified

Resultados de una encuesta nacional sobre hábito transfusional en unidades de cuidados intensivos

et al. 2009

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Introducción. Los hemoderivados son productos clínicos de uso habitual que presentan unas características de escasez, relevancia clínica y de efectos secundarios concomitantes que obligan a conocer y evaluar su utilización con rigurosidad.Objetivo. Analizar actitudes, conocimientos y conductas sobre la política transfusional de las diferentes unidades de cuidados intensivos (UCI) españolas.Diseño. Encuesta mediante correo (electrónico y tradicional) en las unidades de cuidados intensivos. Periodo. Planificación durante 2004 y realización durante todo 2005.Ambito. UCI españolas. Pacientes y método. Cuestionario de 27 preguntas.Resultados. La mayoría son UCI de tamaño medio (10-20 camas), con actividad predominantemente médica. El adjunto, solo o con el residente, suele decidir la transfusión según su experiencia, aunque con tendencia a seguir las recomendaciones científicas. No suele haber comités transfusionales. Cuando se transfunden concentrados de hematíes, suelen ser entre 2 y 4 unidades. La cifra de hemoglobina es orientativa, aunque la decisión es clara si es < 7 g/dl (10 g/dl si hay cardiopatía). No se suele emplear alternativas farmacológicas a las transfusiones por motivos de escasa evidencia y precio. En el 50% de los casos se considera cierta la relación entre transfusión y aumento de mortalidad.Conclusiones. Debemos reflexionar sobre la transfusión y evitar la sobreutilización. Para ello se necesitan protocolos educacionales y conferencias de consensos que establezcan recomendaciones sobre el uso de los hemoderivados y sus alternativas farmacológicas.

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“…An AABB international survey 16 conducted in 2006 indicated that if an implicated donor was found to carry an antibody directed toward an antigen in the recipient, 79% of respondents would defer donation for all blood components from that individual and 14% would defer donation of plasma and platelets only. If a donor was identified as carrying an antibody with no recipient type available, 43% of respondents would defer donation from that individual.…”

Section: Prevention Of Tralimentioning

confidence: 99%