Transfusion-related Acute Lung Injury (TRALI): Current Concepts and Misconceptions

Overview

Journal Blood Rev

Publisher Elsevier

Specialty Hematology

Date 2009 Aug 25

PMID 19699017

Citations 34

Authors

Christopher C Silliman

Yoke Lin Fung

J Bradley Ball

Samina Y Khan

Affiliations

Soon will be listed here.

Abstract

Transfusion-related acute lung injury (TRALI) is the most common cause of serious morbidity and mortality due to hemotherapy. Although the pathogenesis has been related to the infusion of donor antibodies into the recipient, antibody negative TRALI has been reported. Changes in transfusion practices, especially the use of male-only plasma, have decreased the number of antibody-mediated cases and deaths; however, TRALI still occurs. The neutrophil appears to be the effector cell in TRALI and the pathophysiology is centered on neutrophil-mediated endothelial cell cytotoxicity resulting in capillary leak and ALI. This review will detail the pathophysiology of TRALI including recent pre-clinical data, provide insight into newer areas of research, and critically assess current practices to decrease it prevalence and to make transfusion safer.

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