Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2019 Sep;12(9):773-785.
doi: 10.1080/17474086.2019.1640599. Epub 2019 Jul 16.

Risk factors, management and prevention of transfusion-related acute lung injury: a comprehensive update

Susan A Kuldanek  1   2   3 , Marguerite Kelher  4 , Christopher C Silliman  3   4   5
Affiliations
Review

Risk factors, management and prevention of transfusion-related acute lung injury: a comprehensive update

Susan A Kuldanek et al. Expert Rev Hematol. 2019 Sep.

Abstract

Introduction: Despite mitigation strategies that include the exclusion of females from plasma donation or the exclusion of females with a history of pregnancy or known anti-leukocyte antibody, transfusion-related acute lung injury (TRALI) remains a leading cause of transfusion-related morbidity and mortality. Areas covered: The definition of TRALI is discussed and re-aligned with the new Berlin Diagnostic Criteria for the acute respiratory distress syndrome (ARDS). The risk factors associated with TRALI are summarized as are the mitigation strategies to further reduce TRALI. The emerging basic research studies that may translate to clinical therapeutics for the prevention or treatment of TRALI are discussed. Expert opinion: At risk patients, including the genetic factors that may predispose patients to TRALI are summarized and discussed. The re-definition of TRALI employing the Berlin Criteria for ARDS will allow for increased recognition and improved research into pathophysiology and mitigation to reduce this fatal complication of hemotherapy.

Keywords: ALI; ARDS; TRALI; acute lung injury; acute respiratory distress syndrome; management; mitigation; pathogenesis; prevention; risk factors; therapies; transfusion-related acute lung injury; treatment.

PubMed Disclaimer

Conflict of interest statement

Declaration of interests

CC Silliman has acted on a Scientific Advisory Board for Hemanext Corporation. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or conflict with the subject matter or materials discussed in this manuscript apart from those disclosed.

References

    1. Barnard RD. Indiscriminate transfusion: a critique of case reports illustrating hypersensitivity reactions. New York state journal of medicine. 1951. October 15;51(20):2399–402. - PubMed
    1. Popovsky MA, Moore SB. Diagnostic and pathogenetic considerations in transfusion-related acute lung injury. Transfusion. 1985. Nov-Dec;25(6):573–7. - PubMed
    1. Bux J, Sachs UJ. The pathogenesis of transfusion-related acute lung injury (TRALI). Br J Haematol. 2007. March;136(6):788–99. doi: 10.1111/j.1365-2141.2007.06492.x. - DOI - PubMed
    1. Silliman CC, Boshkov LK, Mehdizadehkashi Z, et al. Transfusion-related acute lung injury: epidemiology and a prospective analysis of etiologic factors. Blood. 2003. January 15;101(2):454–62. doi: 10.1182/blood-2002-03-0958. - DOI - PubMed
    1. Toy P, Gajic O, Bacchetti P, et al. Transfusion-related acute lung injury: incidence and risk factors. Blood. 2012. February 16;119(7):1757–67. doi: 10.1182/blood-2011-08-370932. - DOI - PMC - PubMed

    2. **Prospective analysis of patient and transfusion-related risk factors in a general hospital setting

Publication types

MeSH terms

LinkOut - more resources