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[Transfusion associated acute lung injury]

E Omoto1, M Harada

  • 1Division of Blood Transfusion, Okayama University Hospital.

Nihon Rinsho. Japanese Journal of Clinical Medicine
|September 25, 1997
PubMed
Summary

Transfusion-associated acute lung injury (TRALI) is a rare but serious transfusion reaction. Limiting blood components from multiparous donors may help prevent TRALI.

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Area of Science:

  • Hematology
  • Critical Care Medicine
  • Immunology

Background:

  • Transfusion-associated acute lung injury (TRALI) is a rare but severe complication of blood product transfusion.
  • It presents as acute respiratory distress and noncardiogenic pulmonary edema.
  • TRALI is associated with leukoagglutinins in transfused blood products.

Observation:

  • The reported incidence of TRALI is approximately 0.01% per unit transfused.
  • However, only three cases were reported in Japan, suggesting underdiagnosis.
  • TRALI is often misdiagnosed as cardiogenic pulmonary edema or pneumonia.

Findings:

  • Multiparous females have been implicated as donors in TRALI cases.
  • Leukoagglutinins present in transfused components are linked to TRALI development.
  • Underdiagnosis may stem from symptom overlap with other pulmonary conditions.

Implications:

  • Blood collection centers should consider restricting components from multiparous donors.
  • Washed red blood cells may be a safer alternative from at-risk donors.
  • Improved diagnostic criteria and awareness are needed to accurately identify TRALI cases.

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