Severe transfusion-related acute lung injury.
A 46-yr-old man developed severe hypoxemia, pulmonary infiltrates, and an acute decrease in his leukocyte count shortly after transfusion of fresh-frozen plasma (FFP) during recovery from cardiac surgery. Cardiogenic pulmonary edema was excluded. Granulocyte-reactive and agglutinating alloantibodies were detected in the serum of the fresh-frozen plasma donor. The cross-match with the patient's granulocytes revealed antibodies specific for HLA class I. Transfusion-related acute lung injury (TRALI) is a potentially life-threatening, under-recognized and under-reported complication of transfusion. Conservative transfusion strategies and preclusion of the implicated blood donors with granulocyte-reactive antibodies from future blood donation may prevent TRALI and could save lives.


CONCLUSIONS
Transfusion-related acute lung injury (TRALI) is a potentially life-threatening, probably under-recognized and under-reported complication of transfusing blood products. Conservative transfusion strategies and preclusion of the implicated blood donors with granulocyte-reactive antibodies from future blood donation may prevent TRALI and potentially save lives.
Brander
Lukas
L
*Department of Intensive Care Medicine and †Department of Hematology and Central Hematology Laboratory, Division of Transfusion Medicine, University Hospital-Inselspital, Bern, Switzerland; and ‡Blood Transfusion Service, SRC Bern Ltd., Bern, Switzerland.
Reil
Angelika
A
Bux
Juergen
J
Taleghani
Behrouz Mansouri
BM
Regli
Bruno
B
Takala
Jukka
J
D000208:Acute Disease; D000918:Antibody Specificity; D001772:Blood Cell Count; D006348:Cardiac Surgical Procedures; D006098:Granulocytes / Q000276:immunology; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D007518:Isoantibodies / Q000032:analysis; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology; D055370:Lung Injury; D008297:Male; D008875:Middle Aged; D010949:Plasma / Q000276:immunology; D011859:Radiography; D065227:Transfusion Reaction
D007518:Isoantibodies