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Transfusion-related acute lung injury – a frequently undiagnosed reaction following transfusion of blood components

Jolanta Korsak, Anna Łata

Affiliation and address for correspondence
Pediatr Med Rodz 2015, 11 (3), p. 250–258
DOI: 10.15557/PiMR.2015.0023
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Abstract

Transfusion-related acute lung injury is the leading cause of mortality following transfusion of blood components. Its characteristic feature is acute hypoxaemia during or 6 hours after transfusion. The syndrome should be differentiated from cardiogenic respiratory failure and transfusion-associated circulatory overload. This article presents: 1) The aetiology and pathomechanism of transfusion-related acute lung injury, which are still not fully understood despite numerous studies. The model currently accepted is the multi-event one which involves both factors related to the patient and to the transfused blood components. Transfusion-related acute lung injury may be either immunological, with anti-HLA/HNA antibodies in blood components, or non-immunological, with no antibodies. 2) The diagnosis of transfusion-related acute lung injury which is based on clinical signs, evidence of the relationship with blood component transfusion and detection of antibodies. 3) The treatment and prevention of transfusion-related acute lung injury. The most important element in the prevention of transfusion-related acute lung injury is a reduction in blood component transfusion, particularly of plasma and platelet concentrate. Yet, further studies on larger groups of patients are necessary to specify the limitations of blood component transfusion.

Keywords
transfusion-related acute lung injury (TRALI), anti-HLA antibodies, anti-HNA antibodies, blood components, DAMPs

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