title: Low-risk transfusion-related acute lung injury donor strategies and the impact on the onset of transfusion-related acute lung injury: a meta-analysis.
abstract: BACKGROUND
  Transfusion-related acute lung injury (TRALI) is the leading cause of transfusion-related mortality. In the past decade blood banks have implemented low-risk TRALI donor strategies, including a male-only donor policy for plasma-containing blood products to prevent onset of TRALI. We performed a meta-analysis to determine whether use of low-risk TRALI donor strategies for plasma indeed reduces onset of TRALI.
  
  
  METHODS
  We searched MEDLINE and Cochrane Central Register of Controlled Trials from January 1995 up to January 2013. Two reviewers independently extracted data on study characteristics, methods, and outcomes. Primary endpoint was onset of TRALI. Subgroup analyses were performed for patient populations prone to develop TRALI and general patient populations.
  
  
  RESULTS
  Ten articles were included. Meta-analysis using a random-effects model taking into account all transfused products showed a significant reduction for the risk of TRALI after implementation of low-risk TRALI donor strategies (odds ratio [OR], 0.61; 95% confidence interval [CI], 0.42-0.88). Data from patient populations prone to develop TRALI showed a significant reduction of TRALI risk (OR, 0.51; 95% CI, 0.29-0.90), while data from general patient populations showed a similar nonsignificant trend (OR, 0.66; 95% CI, 0.40-1.09). Results were similar when taking only plasma products into account (OR, 0.62; 95% CI, 0.42-0.92).
  
  
  CONCLUSIONS
  The introduction of low-risk TRALI donor strategies for plasma-containing products results in a reduction of TRALI.
authors.affiliation: Department of Intensive Care Medicine, Academic Medical Center, Amsterdam, The Netherlands; Laboratory of Experimental Intensive Care and Anesthesiology (LEICA), Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Marcella C A
authors.initials: MC
authors.lastname: Müller
authors.forename: Danielle
authors.initials: D
authors.lastname: van Stein
authors.forename: Jan M
authors.initials: JM
authors.lastname: Binnekade
authors.forename: Dick J
authors.initials: DJ
authors.lastname: van Rhenen
authors.forename: Alexander P J
authors.initials: AP
authors.lastname: Vlaar
mesh_terms: D055371:Acute Lung Injury / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D001782:Blood Donors; D001803:Blood Transfusion / Q000401:mortality; D016022:Case-Control Studies; D046148:Donor Selection / Q000592:standards*; D006801:Humans; D008297:Male; D064887:Observational Studies as Topic; D010949:Plasma; D012107:Research Design; D012128:Respiratory Distress Syndrome / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D012189:Retrospective Studies; D040242:Risk Reduction Behavior; D065227:Transfusion Reaction / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*