title: Conversion to low transfusion-related acute lung injury (TRALI)-risk plasma significantly reduces TRALI.
abstract: BACKGROUND
  Transfusion-related acute lung injury (TRALI) is an uncommon but serious transfusion reaction. Studies have shown that the transfusion of HLA and HNA antibodies in donor plasma can lead to TRALI. Female donors are more likely to have such antibodies due to alloantigen exposure during pregnancy. Many blood suppliers have now implemented various TRALI risk reduction strategies to unknown effect. A retrospective analysis of TRALI reactions in plasma recipients before and after the conversion to low-TRALI-risk plasma (all-male donor plasma, male-predominant plasma, nulliparous female plasma, and HLA antibody-tested plasma) is reported.
  
  
  METHODS
  Transfusion reaction reports at three large hospitals 16 months before and 16 months after the conversion to low-TRALI-risk plasma were analyzed. Respiratory reactions were categorized as TRALI, possible TRALI, or other (e.g., transfusion-associated circulatory overload or allergic reactions). Reactions were reported as a percentage of total units transfused and rates for the two time periods were compared. Trends in reaction rates for other components were also compared.
  
  
  RESULTS
  A total of 2156 transfusion reactions in association with 461,598 transfused blood components were reviewed. The incidence of combined TRALI or possible TRALI reactions, due to the transfusion of plasma, decreased from 0.0084% to zero (p = 0.052). The rate of TRALI or possible TRALI reactions in red blood cell and platelet recipients did not change significantly.
  
  
  CONCLUSIONS
  The conversion to low-TRALI-risk plasma has reduced the incidence of TRALI reactions in plasma recipients.
authors: New York Blood Center and the Department of Pathology and Laboratory Medicine, Weill Cornell Medical Center, 525 E. 68th Street, New York,NY 10065, USA.
authors: Suzanne A
authors: SA
authors: Arinsburg
authors: Donna L
authors: DL
authors: Skerrett
authors: Julie K
authors: JK
authors: Karp
authors: Paul M
authors: PM
authors: Ness
authors: Jeffrey
authors: J
authors: Jhang
authors: Anand
authors: A
authors: Padmanabhan
authors: Joan
authors: J
authors: Gibble
authors: Joseph
authors: J
authors: Schwartz
authors: Karen E
authors: KE
authors: King
authors: Melissa M
authors: MM
authors: Cushing
mesh_terms: D055371:Acute Lung Injury / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012306:Risk; D065227:Transfusion Reaction