title: A touch of TRALI.
abstract: Transfusion-related acute lung injury (TRALI) is a leading cause of transfusion-associated morbidity and mortality. The National Heart, Lung, and Blood Institute (NHLBI) and Canadian Consensus Conference definitions of TRALI exclude cases of mild TRALI. As a result, many cases of mild TRALI are likely to be missed. Three cases are reported in which patients experienced the acute onset of breathlessness in association with transfusion of blood components containing human leukocyte antigen (HLA) antibodies reactive with recipient HLA antigens. Despite the sudden onset of a pulmonary syndrome in association with transfusion, clinicians caring for these patients did not consider TRALI, and no case would meet recent consensus definitions. Nevertheless, supporting clinical and serologic evidence for TRALI was found in each case. Benefits in recognizing mild cases of TRALI include quantifying the true incidence of TRALI, understanding the physiology of mild versus severe TRALI, and preventing subsequent cases of TRALI due to donors found to have HLA antibodies.
authors: Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts 02114-2696, USA. akdavis@partners.org
authors: Amanda
authors: A
authors: Davis
authors: Rajni
authors: R
authors: Mandal
authors: Matthew
authors: M
authors: Johnson
authors: Robert
authors: R
authors: Makar
authors: Christopher
authors: C
authors: Stowell
authors: Sunny
authors: S
authors: Dzik
mesh_terms: D000328:Adult; D000368:Aged; D000906:Antibodies / Q000276:immunology; D005260:Female; D006680:HLA Antigens / Q000276:immunology; D006801:Humans; D008297:Male; D012128:Respiratory Distress Syndrome / Q000209:etiology / Q000276:immunology / Q000473:pathology*; D065227:Transfusion Reaction
chemical_list: D000906:Antibodies; D006680:HLA Antigens