Blood donor and component management strategies to prevent transfusion-related acute lung injury (TRALI).
OBJECTIVE
Discuss the pros and cons of using donor and blood product-management strategies to prevent transfusion-related acute lung injury (TRALI).


METHODS
A review of the literature was performed.


RESULTS
Despite therapeutic advances in pulmonary and critical care medicine, TRALI is now considered to be one of the leading causes of transfusion-associated mortality, and thus determining how to prevent TRALI is extremely important. Donor and product-management strategies to prevent this life-threatening condition have been suggested, but because of gaps in our understanding of TRALI, blood-bankers do not know how beneficial these interventions will be, nor the amount of potential harm-such as decreasing the availability of blood-that could arise if they were implemented. This article discusses the advantages and disadvantages of the various preventive measures that have been described in the literature.


CONCLUSIONS
Preventing TRALI poses a difficult challenge for blood-banking experts, because it is unknown which measures will be effective in decreasing the incidence of TRALI and which could have significant drawbacks. Only additional research into TRALI prevention will provide the answers on how to best protect patients from this potentially fatal reaction.
Mair
D C
DC
American Red Cross-North Central Blood Services, St. Paul, MN, USA.
Hirschler
Nora
N
Eastlund
Ted
T
D001782:Blood Donors; D001803:Blood Transfusion / Q000379:methods*; D016638:Critical Illness; D006801:Humans; D047589:Leukocyte Reduction Procedures; D012128:Respiratory Distress Syndrome / Q000209:etiology* / Q000276:immunology / Q000517:prevention & control*; D065227:Transfusion Reaction