transfusion-related acute lung injury


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transfusion-related acute lung injury

adult respiratory distress syndrome (ARDS) occurring within 4 hours of transfusion. The estimated frequency is 1 in 5000 transfusions and the mechanism remains poorly understood. The prognosis is much better than with most other cases of ARDS.
See also: adult respiratory distress syndrome.

transfusion-related acute lung injury

Transfusion medicine
1. A type of ARDS characterized by acute noncardiogenic pulmonary edema–pulmonary white-out–and hypoxia within 4 hrs of transfusing a blood product from a multiparous donor containing plasma with potent antigranulocytic antibodies. See Adult respiratory distress syndrome.
2. A nonimmune response to transfusion of packed RBCs, attributed to platelet-specific antibodies Clinical Severe thrombocytopenia–eg, < 10 x 109/L–5–10 days after packed RBCs in Pt sensitized by prior transfusion or pregnancy Management Steroids, IVIG Prognosis Spontaneous recovery. See Transfusion.

trans·fu·sion-re·lated a·cute lung in·ju·ry

(trans-fyūzhŭn-rē-lātĕd ă-kyūt lŭng injŭr-ē)
Adult respiratory distress syndrome (ARDS) occurring within 4 hours of transfusion; mechanism remains poorly understood. The prognosis is much better than with most other cases of ARDS.
References in periodicals archive ?
Diagnostic and pathogenetic consideration in transfusion-related acute lung injury. Transfusion 1985;25:573-7.
Diagnostic and pathogenetic considerations in transfusion-related acute lung injury. Transfusion 1985;25:573-7.
At a meeting of the FDA's Blood Products Advisory Committee in April, the panel agreed in a 13 to 0 vote that the use of predominantly male plasma for transfusions would reduce the incidence of transfusion-related acute lung injury (TRALI), the leading cause of transfusion-related deaths reported to the FDA over the past 3 years.
Washing red blood cells also clears away many immune globulins, which are proteins that cause a lung problem called transfusion-related acute lung injury. This side effect occurs once for every 5,000 transfusions.
Among these are febrile nonhemolytic transfusion reactions often associated with recipient white cell antibodies, transfusion-related acute lung injury attributed to donor white cell antibodies, and anaphylaxis, which is not uncommon with IgA antibodies.
There have been accumulating studies, include healthy volunteers, retrospective and prospective observational studies, and randomized controlled trials (RCTs), investigating the effects of stored RBC transfusion on clinical outcomes (e.g., infection, sepsis, transfusion-related acute lung injury, multi-organ dysfunction and failure, myocardial infarction, thrombotic complications, and mortality, etc.).
(5.) Kopko PM, Marshall CS, MacKenzie MR, et al: Transfusion-related acute lung injury: report of a clinical look-back investigation.
Mehdizadehkashi et al., "Transfusion-related acute lung injury: epidemiology and a prospective analysis of etiologic factors," Blood, vol.
The haemovigilance data from many countries showed that transfusion-related acute lung injury (TRALI) was a significant risk of transfusion.
The lungs are affected in the most common of the severe transfusion reactions, eg transfusion-related acute lung injury and transfusion-associated cardiac overload, as well as the less severe allergic reactions.
Transfusion-related acute lung injury (TRALI) deserves mention in the discussion of DAD/ARDS, as TRALI is increasingly recognized from a clinical standpoint.
Perioperative blood transfusion is associated with greater postoperative complications (Table 1), including nosocomial infections, immune-suppression, transfusion-related acute lung injury, decreased health-related quality of life, and reduced early and long-term survival.

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