The pathogenesis of transfusion-related acute lung injury and how to avoid this serious adverse reaction of transfusion.
Transfusion-related acute lung injury (TRALI) is a serious, life-threatening complication of blood transfusion. Available evidence strongly suggests that leukocyte antibodies present in donor plasma are the predominant mechanism in TRALI. These antibodies lead to recipient neutrophil activation, with activated neutrophils inducing endothelial and alveolar damage in the lungs. These mechanisms are discussed in detail as are the alternative mechanisms that have been proposed. Preventive strategies that may help to reduce TRALI are presented.
Sachs
Ulrich J H
UJ
Institute for Clinical Immunology and Transfusion Medicine, Justus Liebig University, Langhansstrasse 7, D-35392 Giessen, Germany. ulrich.sachs@med.uni-giessen.de
D000906:Antibodies / Q000276:immunology; D006801:Humans; D018375:Neutrophil Activation / Q000276:immunology; D009504:Neutrophils / Q000276:immunology / Q000473:pathology; D010949:Plasma / Q000276:immunology; D012128:Respiratory Distress Syndrome / Q000209:etiology* / Q000276:immunology / Q000473:pathology / Q000517:prevention & control*; D065227:Transfusion Reaction
D000906:Antibodies