輸血による急性肺損傷:臨床レビュー

Alexander P J Vlaar¹, Nicole P Juffermans

¹Department of Intensive Care Medicine, Academic Medical Centre, Amsterdam, Netherlands.

Lancet (London, England)

|May 7, 2013

まとめ

輸血による急性肺損傷 (TRALI) は,輸血による死亡の主な原因である. 特定の女性ドナーを除外し,患者のリスク要因を特定するなどの戦略は,TRALIの発生率を低下させています.

科学分野:

輸血医学とは
免疫学免疫学とは
クリティカルケア・メディシン

背景:

輸血による急性肺損傷 (TRALI) は,かつてまれでしたが,現在は輸血による死亡の主な原因となっています.
TRALIの病原性を理解することで,血液バンクの観点から予防戦略が生まれました.

研究の目的:

TRALIの理解と管理の進化をレビューする.
主要な予防戦略と新興の患者特異的リスク要因を強調する.

主な方法:

輸血医療に関する文献のレビューと規制当局の承認.
TRALIの発生率と死亡率に関する疫学データの分析.
ドナー排除と患者リスク分層化戦略の特定.

主要な成果:

高血量製品の女性ドナーを除外すると,TRALIの発症率は約3分の2に減少しました.
予防的措置にもかかわらず,TRALIは重要な臨床的懸念事項であり続けています.
TRALIの患者に関連するリスク要因が特定され,個別化された輸血アプローチが可能になりました.

結論:

TRALIの予防は,ドナーのスクリーニングとリスクファクターの特定を通じて著しく進歩しました.
患者特異的な要因に関するさらなる研究は,TRALIの完全根絶に不可欠です.
輸血管理の個別化されたアプローチは,患者の安全のために不可欠です.

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