Toward an understanding of transfusion‐related acute lung injury: statement of a consensus panel

Abstract

Conference; ALI = acute lung injury; HMVEC(s) = human pulmonary microvascular endothelial cell(s); HNA(s) = human neutrophil antigen(s); LPS = lipopolysaccharide; lyso-PC(s) = lysophosphatidylcholine(s); SHOT = Serious Hazard of Transfusion.ransfusion-related acute lung injury (TRALI) is an uncommon clinical complication of allogeneic blood transfusion. Despite its increasing recognition over the past 5 years, much about TRALI remains poorly understood and controversial. Outstanding issues include the lack of a universally accepted case definition, uncertainty about incidence and pathogenesis, and disagreement about both how to manage

Clinical review: Prothrombin complex concentrates - evaluation of safety and thrombogenicity

“…Human plasma transfusion is associated with other potential adverse reactions, including transfusion-related acute lung injury and allergic reaction [39]. FFP is also associated with a risk of allergic reactions, such as skin rash, pruritus, urticaria, bronchospasm, angioedema and anaphylactic shock [40].…”

The incidence, risk factors, and outcome of transfusion-related acute lung injury in a cohort of cardiac surgery patients: a prospective nested case-control study

“…28 Possible TRALI was defined using the consensus definition of TRALI (new onset hypoxemia or deterioration demonstrated by arterial oxygen tension/fraction of inspired oxygen Ͻ 300 mmHg, within 6 hours after transfusion, with bilateral pulmonary changes, in the absence of elevated left atrial pressure defined as a pulmonary arterial occlusion pressure less than or equal to 18 mmHg). 1,3,5 Chest radiographs were routinely taken before surgery and on arrival at the ICU and scored for the presence of new onset bilateral interstitial abnormalities by 2 independent physicians blinded to the predictor variables. When interpretation differed, chest radiograph and the description by the radiologist were reviewed to receive consensus.…”

“…[1][2][3][4] TRALI is defined as the acute onset of hypoxia and bilateral pulmonary infiltrates, in temporal relation to a blood transfusion. 1,5 Although the absence of specific disease markers and diagnostic tests has resulted in a large variation in estimations of incidence, 1,[6][7][8][9][10][11][12][13][14] TRALI is generally considered to be a rare event.…”

Transfusion Related Acute Lung Injury in the Canadian Paediatric Population

“…Estimates in the literature range from one in 432 to one in 725,000 units, depending on the type of product considered, the case definition of TRALI used, and the nature and size of the denominator (17)(18)(19)(20). According to data collected by the Quebec Hemovigilance System (QHS), the incidence of TRALI was one per 23,506 units transfused during the period from 2000 to 2005 (21).…”

“…Such a definition was developed at a consensus conference held in Toronto (Ontario) in April 2004 (11,17), which has allowed for better comparisons of Original article ©2012 Pulsus Group Inc. All rights reserved BaCkGRound: The incidence of transfusion-related acute lung injury (TRALI) in adults is approximately one per 5000 transfusions. The Canadian Paediatric Surveillance Program undertook the present study to determine the incidence of TRALI in the paediatric population and to describe the characteristics and outcomes of children with TRALI.…”