Transfusion-related acute lung injury

Area of Science:

• Transfusion Medicine
• Pulmonary Medicine
• Critical Care

Background:

• Transfusion-related acute lung injury (TRALI) is a serious adverse event following blood product transfusion.
• TRALI is characterized by acute hypoxemia, dyspnea, fever, hypotension, and noncardiogenic pulmonary edema.
• The reported mortality rate for TRALI is 16.3%, with potential for underestimation due to under-recognition.

Purpose of the Study:

• To review the current understanding of transfusion-related acute lung injury (TRALI).
• To discuss the incidence, clinical presentation, and mortality associated with TRALI.
• To explore the proposed etiologies and highlight the need for further research and education.

Main Methods:

• Literature review of TRALI cases and definitions.
• Analysis of clinical hallmarks and diagnostic criteria.
• Examination of proposed etiological theories, including antibody and two-hit hypotheses.

Main Results:

• TRALI occurs in approximately 1 in 5,000 transfusions.
• Key clinical features include hypoxemia, dyspnea, fever, hypotension, and bilateral pulmonary edema.
• A consensus definition for TRALI was established in 2004, but the exact cause remains unidentified.

Conclusions:

• TRALI poses a significant risk to patients receiving blood transfusions.
• Both donor and recipient factors are implicated in TRALI pathogenesis.
• Further research and education are essential for developing effective prevention and treatment strategies for TRALI.