title: Pathology consultation on transfusion-related acute lung injury (TRALI).
abstract: Transfusion-related acute lung injury (TRALI) is a serious condition characterized by respiratory distress, hypoxia, and bilateral pulmonary infiltrates, which occur within 6 hours of transfusion. Several theories have been proposed to explain the underlying pathologic mechanisms of TRALI. Immune-mediated TRALI accounts for over 80% of reported cases and is mediated by donor antibodies to HLAs and/or human neutrophil antigens (HNA). Immune-mediated TRALI is most commonly associated with donor plasma transfusion or other blood products from multiparous women, which has led many countries to reduce or exclude women from donating high-volume plasma products. This policy change has resulted in a decrease in the incidence of TRALI and highlighted the importance of nonimmune-mediated TRALI, which is thought to be caused by bioreactive lipids and other biologic response modifiers that accumulate during storage of blood products. When TRALI is suspected, clinical consultation with a transfusion medicine specialist helps differentiate it from other transfusion reactions with similar characteristics.
authors.affiliation: Department of Pathology, University of Alabama at Birmingham, AL, USA.
authors.forename: Amy E
authors.initials: AE
authors.lastname: Schmidt
authors.forename: Jill
authors.initials: J
authors.lastname: Adamski
mesh_terms: D055371:Acute Lung Injury / Q000175:diagnosis* / Q000209:etiology* / Q000276:immunology; D000328:Adult; D001782:Blood Donors; D046148:Donor Selection; D005260:Female; D006801:Humans; D000860:Hypoxia / Q000209:etiology / Q000276:immunology / Q000473:pathology; D008297:Male; D010298:Parity / Q000276:immunology; D010336:Pathology; D011654:Pulmonary Edema / Q000209:etiology / Q000276:immunology / Q000473:pathology; D012017:Referral and Consultation; D012128:Respiratory Distress Syndrome / Q000209:etiology / Q000276:immunology / Q000473:pathology; D065227:Transfusion Reaction