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Case Reports
. 2022 Mar;62(3):594-599.
doi: 10.1111/trf.16822. Epub 2022 Feb 17.

Reported transfusion-related acute lung injury associated with solvent/detergent plasma - A case series

Robert B Klanderman  1   2   3 , Esther B Bulle  1   2 , Josephine W M Heijnen  4 , Judith Allen  5 , Ilse M Purmer  6 , Jean-Louis H Kerkhoffs  5 , Johanna C Wiersum-Osselton  4 , Alexander P J Vlaar  1   2
Affiliations
Case Reports

Reported transfusion-related acute lung injury associated with solvent/detergent plasma - A case series

Robert B Klanderman et al. Transfusion. 2022 Mar.

Abstract

Background: Antibody-mediated transfusion-related acute lung injury (TRALI) is caused by donor HLA or HNA antibodies in plasma-containing products. In the Netherlands 55,000 units of solvent/detergent plasma (SDP), a pooled plasma product, are transfused yearly. It's produced by combining plasma from hundreds of donors, diluting harmful antibodies. Due to a lack of reported cases following implementation, some have labeled SDP as "TRALI safe".

Study design and methods: Pulmonary transfusion reactions involving SDP reported to the Dutch national hemovigilance network in 2016-2019 were reviewed. Reporting hospitals were contacted for additional information, cases with TRALI and imputability definite, probable, or possible were included and informed consent was sought.

Results: A total of three TRALI and nine TACO cases were reported involving SDP. The imputability of one TRALI case was revised from possible to unlikely and excluded; in one case no informed consent was obtained. We present a case description of TRALI following SDP transfusion in a 69-year-old male, 3 days following endovascular aortic aneurysm repair. The patient received one unit of SDP to correct a heparin-induced coagulopathy, prior to removal of a spinal catheter post-operatively. Within five hours he developed hypoxemic respiratory failure requiring intubation, hypotension, bilateral chest infiltrates, and leucopenia. The patient made a full recovery.

Conclusion: This case of TRALI, following transfusion of a single unit of SDP to a patient without ARDS risk factors, demonstrates that TRALI can occur with this product. Clinicians should remain vigilant and continue to report suspected cases, to help further understanding of SDP-associated TRALI.

Keywords: SDP; TRALI; plasma; solvent/detergent.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

FIGURE 1
FIGURE 1
Case 1 chest x‐ray. Panel A: 3 h:15 min after start of transfusion. Perihilar alveolar edema is present, with bilateral patchy consolidations visible. Panel B: 2‐days post‐transfusion: Improvement of consolidations in the lung fields bilaterally
See this image and copyright information in PMC

References

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