![]() ![]() Other literature mentioned female donor plasma has larger quantities of anti-HLA class II and HNA positive antibodies. Blood products that have high plasma contents have been associated with an increased rate of TRALI. ![]() Higher TRALI incidence was reported with plasma from female donors because the literature found parous female donors with multiple HLA antibodies. In the US, TRALI has to be reported to the Blood Banking services.Ĭomorbidities suggest risk factors for having TRALI, mechanical ventilation, sepsis, massive transfusion, coronary artery bypass graft, and end-stage liver disease. Transfusion-related circulatory overload (TACO) needs to be ruled out as it can be on differential diagnosis due to the similarity of pulmonary edema picture, but due to actual volume overload. Delayed TRALI is when transfusion is completed after 6 to 72 hours, and it is associated with higher mortality. Possible TRALI is when there are other risk factors for acute lung injury. Physical symptoms include fever, hypotension, and tachycardia. Clinical findings include exudative bilateral infiltrates on chest radiograph, no evidence of pulmonary vascular overload, and hypoxemia of SpO2 less than 90% on room air with a ratio of the partial pressure of oxygen to a fractional inspired oxygen concentration of less than 300 mmHg. Diagnostic criteria for TRALI is if the symptoms develop during or within 6 hours of transfusion without any risk factors for developing acute lung injuries such as sepsis from pneumonia, aspiration, and shock. The disorder is not only diagnosed clinically but is usually confirmed by radiographic findings. TRALI was first reported in the 1950s but recognized as a distinctive clinical syndrome in 1983. Specifically, an incident of TRALI includes 1 in 5000 units of packed red blood cells, 1 in 2000 plasma-containing components, and 1 in 400 units of whole-blood-derived platelet concentrates. It is the leading cause of death from transfusion documented by the U.S. Transfusion-related acute lung injury (TRALI), is a clinical syndrome in which there is acute, noncardiogenic pulmonary edema associated with hypoxia that occurs during or after a transfusion. Transfusion reactions are adverse events that occur after transfusing blood products such as whole blood, fresh frozen plasma (FFP), platelets, cryoprecipitate, granulocytes, intravenous immune globulin, allogenic and autologous stem cells, and packed red blood cells. ![]()
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