Reporting transfusion-related acute lung injury cases

Transfusion-related acute lung injury (TRALI) is a rare but potentially fatal complication of blood product transfusion. It is felt worldwide that TRALI is an underrecognized and underreported entity because of lack of awareness.

The purpose of this study was to report all cases of TRALI diagnosed in a tertiary care hospital over a 5-year period.

This is a retrospective review of all TRALI cases reported from January 2011 to December 2015. All TRALI cases were identified from a manual review of reported transfusion reaction forms. For detailed information of all TRALI cases, medical record charts of patients were reviewed. The record of donors implicated in TRALI cases was derived from blood bank system.

The rate of TRALI cases per 1000 blood products transfused was computed by dividing the transfusion reactions by total number of all blood units transfused.

Total number of transfusions during the study was 291,041. Six cases of TRALI were reported during this period. Rate of TRALI per 1000 units transfused was 0.02%. The mortality associated with TRALI was 33.3%. TRALI occurred following the transfusion of fresh-frozen plasma in one patient, packed red blood cells in two patients, and a mixture of blood components in three patients. In all cases, the donors were male.

The rate of TRALI reported to our blood bank was found to be 0.02%, which is very low as compared to international data. This is the first comprehensive study on TRALI from the country and a step forward to create awareness about the importance of diagnosing and reporting TRALI.