title: The impact of policies to restrict the use of plasma containing products and apheresis platelets from female donors to mitigate transfusion related acute lung injury (TRALI) in Brazil.
abstract: OBJECTIVE
  Although the incidence of TRALI is unknown in Brazil, some blood centers have adopted strategies to prevent TRALI. We evaluated the impact of three policies to mitigate TRALI on the supply of blood products: to divert the production of whole blood-derived plasma from female donors; to defer all female donors from apheresis platelet collections, and to defer only multiparous female donors from apheresis platelet collections.
  
  
  METHODS
  Data from allogeneic whole blood and apheresis platelet donations from April 2008 to December 2009 were collected in three Brazilian blood centers and the impact of the aforementioned strategies was evaluated.
  
  
  RESULTS
  Of 544,814 allogeneic blood donations, 30.8% of whole blood plasma and 24.1% of apheresis platelet donations would be reduced if only male donor plasma was issued for transfusion and all female donors were deferred from apheresis donation, respectively. If only multiparous donors were deferred from apheresis donation, there would be a 5% decrease of all apheresis platelet collections.
  
  
  CONCLUSIONS
  Restricting the use of whole blood derived plasma to male-only donors and deferring all female apheresis platelet donors would impact two out of three Brazilian blood centers. A deferral policy on multiparous apheresis platelet donors may be acceptable as a temporary measure, but may cause more stress on a system that is already working at its limit.
authors.affiliation: Fundacão Pró-Sangue Hemocentro de São Paulo, SP, Brazil. pblatyta@yahoo.com.br
authors.forename: Paula Fraiman
authors.initials: PF
authors.lastname: Blatyta
authors.forename: Brian
authors.initials: B
authors.lastname: Custer
authors.forename: Jing
authors.initials: J
authors.lastname: Liu
authors.forename: Alfredo
authors.initials: A
authors.lastname: Mendrone-Junior
authors.forename: David J
authors.initials: DJ
authors.lastname: Wright
authors.forename: Silvana Carneiro
authors.initials: SC
authors.lastname: Leão
authors.forename: Maria Inês
authors.initials: MI
authors.lastname: Lopes
authors.forename: Anna Bárbara
authors.initials: AB
authors.lastname: Carneiro-Proietti
authors.forename: Ester Cerdeira
authors.initials: EC
authors.lastname: Sabino
authors.forename: Cesar
authors.initials: C
authors.lastname: de Almeida-Neto
mesh_terms: D055371:Acute Lung Injury / Q000209:etiology* / Q000628:therapy; D000328:Adult; D001781:Blood Component Removal / Q000009:adverse effects / Q000379:methods / Q000592:standards*; D001938:Brazil; D005260:Female; D006801:Humans; D008875:Middle Aged; D017713:Platelet Transfusion / Q000009:adverse effects / Q000379:methods / Q000592:standards*