Related Experiment Video
Updated: Jun 28, 2026
06:10
A Simple Double Centrifugation Tube Method to Obtain Platelet-rich Plasma from Equine Blood
Published on: August 15, 2025
How much residual plasma may cause TRALI?
N Win1, C E Chapman, K M Bowles
1Red Cell Immunology Department, National Blood Service, Tooting Centre, London. nay.win@nhsbt.nhs.uk
Transfusion Medicine (Oxford, England)
|October 22, 2008
Summary
Even small volumes of residual plasma (10-20 mL) containing white blood cell (WBC) antibodies can cause transfusion-related acute lung injury (TRALI). This risk persists even with pooled platelets in male plasma, highlighting antibody presence as key.
Area of Science:
- Hematology
- Immunology
- Transfusion Medicine
Background:
- Transfusion-related acute lung injury (TRALI) is a serious adverse event often linked to passive antibody transfer.
- The minimum volume of residual plasma triggering TRALI remains undetermined, posing a risk in component transfusions.
Observation:
- Three TRALI cases were identified involving residual plasma volumes of 10-20 mL.
- Affected components included red blood cells and pooled buffy coat platelets.
- Donor serum contained multiple human leucocyte antigen (HLA) antibodies matching patient HLA types.
Findings:
- Residual plasma as low as 10-20 mL, containing donor-derived WBC antibodies, can induce TRALI.
- Pooled platelets suspended in male plasma did not eliminate TRALI risk if antibody presence was high.
- Multiple HLA antigen/antibody mismatches between donor and recipient are significant in immune TRALI.
Implications:
- Clinicians should consider the risk of TRALI even with minimal residual plasma volumes.
- Current strategies for pooled platelet preparation may not fully mitigate TRALI risk.
- Further research into HLA matching is crucial for preventing immune-mediated TRALI.
Related Concept Videos
01:29Drug Distribution: Plasma Protein Binding
Drugs predominantly attach to plasma proteins, with only a small percentage remaining unbound. The unbound portion can be calculated as one minus the bound fraction. Acidic drugs form large, inactive complexes by reversibly binding to plasma albumin, which prevents them from diffusing across biological barriers. These drug-protein complexes act as reservoirs for the drugs. As the concentration of unbound drugs decreases, these complexes quickly dissociate to release the free drug, maintaining...
01:24Composition of Blood Plasma
Blood plasma is a fluid that contains approximately 92% water and 8% solutes. The solutes include various types of proteins, which constitute about 7% of the total solutes in the plasma. The high-molecular-weight proteins—albumins, globulins, and fibrinogen—are essential to plasma function. Albumins, making up about 60% of the plasma proteins, maintain the osmotic balance within blood vessels by preventing excessive water leakage. Additionally, albumins serve as carrier proteins, binding to...
01:24Hemodialysis II: Procedure and Complications
DialyzersA hemodialysis (HD) dialyzer is a plastic cartridge containing thousands of parallel hollow fibers, which serve as semipermeable membranes. These fibers are typically made from cellulose-based or other synthetic materials. During HD, blood is pumped into the top of the cartridge and distributed among these fibers. Simultaneously, dialysis fluid, known as dialysate, is introduced into the bottom of the cartridge, bathing the outside of the fibers. Across the semipermeable membrane,...
01:26Extracorporeal Removal of Drugs: Continuous Renal Replacement Therapy
Continuous Renal Replacement Therapy (CRRT) is an essential intervention for patients experiencing severe kidney dysfunction. This therapy offers a continuous mechanism for removing fluids and toxins from the bloodstream, leveraging the patient’s blood pressure to facilitate filtration through a specialized filter. This method contrasts with intermittent dialysis, providing a gentler and more consistent removal of waste products and excess fluid, which is particularly beneficial in critically...
02:45Blood Transfusion and Agglutination
Blood transfusion is a therapeutic measure to restore the blood volume after extensive blood loss due to an accident or a medical procedure. Blood transfusion involves drawing a certain amount of blood from a suitable donor and infusing it into the recipient.
History
The history of blood transfusion dates back to the 17th century, when early attempts were made in animals. In 1818 James Blundell, a British doctor, performed the first successful human blood transfusion. Later in 1900, Karl...
History
The history of blood transfusion dates back to the 17th century, when early attempts were made in animals. In 1818 James Blundell, a British doctor, performed the first successful human blood transfusion. Later in 1900, Karl...
01:30Continuous Renal Replacement Therapy
Continuous Renal Replacement Therapy, also known as CRRT, is a procedural treatment for acute kidney injury (AKI) that gradually removes uremic toxins and fluids while maintaining acid-base balance and stabilizing electrolytes. It is particularly useful for hemodynamically unstable patients. Unlike intermittent hemodialysis, which is faster, CRRT provides a gentler approach over 24 hours, closely mimicking the function of natural kidneys. However, CRRT is not ideal for patients with...