Transfusion-related acute lung injury: definition and review.
BACKGROUND
Transfusion-related acute lung injury (TRALI) is now the leading cause of transfusion-associated mortality, even though it is probably still underdiagnosed and underreported.
The National Heart, Lung, and Blood Institute convened a working group to identify areas of research needed in TRALI. The working group identified the immediate need for a common definition and thus developed the clinical definition in this report.
The major concept is that TRALI is defined as new acute lung injury occurring during or within 6 hrs after a transfusion, with a clear temporal relationship to the transfusion. Also, another important concept is that acute lung injury temporally associated with multiple transfusions can be TRALI, because each unit of blood or blood component can carry one or more of the possible causative agents: antileukocyte antibody, biologically active substances, and other yet unidentified agents.


CONCLUSIONS
Using the definition in this report, clinicians can diagnose and report TRALI cases to the blood bank; importantly, researchers can use this definition to determine incidence, pathophysiology, and strategies to prevent this leading cause of transfusion-associated mortality.
Toy
Pearl
P
School of Medicine, University of California-San Francisco, San Francisco, CA 94143-0100, USA.
Popovsky
Mark A
MA
Abraham
Edward
E
Ambruso
Daniel R
DR
Holness
Leslie G
LG
Kopko
Patricia M
PM
McFarland
Janice G
JG
Nathens
Avery B
AB
Silliman
Christopher C
CC
Stroncek
David
D
D001803:Blood Transfusion / Q000706:statistics & numerical data*; D014943:Global Health; D006801:Humans; D015994:Incidence; D017410:Practice Guidelines as Topic; D012128:Respiratory Distress Syndrome / Q000175:diagnosis* / Q000453:epidemiology* / Q000209:etiology; D012307:Risk Factors; D013577:Syndrome; D065227:Transfusion Reaction