title: Proposed revised nomenclature for transfusion-related acute lung injury.
abstract: A decade ago, definitions of "transfusionߚrelated acute lung injury (TRALI)" and "possible TRALI" were standardized for research and clinical diagnosis. Since then, evidence has confirmed that TRALI is often due to transfusion of white blood cell antibodies to at-risk patients, and the term "TRALI, antibody mediated" is appropriate for such cases. Other TRALI cases are non-antibody mediated. Because specific, nonantibody transfusion factors have not yet been confirmed to cause TRALI in humans, the general term "TRALI, non-antibody mediated" is appropriate for such cases. In contrast, evidence is against possible TRALI being due to transfusion with the more likely cause of the acute respiratory distress syndrome (ARDS) being the alternative ARDS risk factor present in these patients. We propose to drop the misleading term "possible TRALI" and to rename this category of cases as "transfused ARDS." These nomenclature updates will more accurately categorize ARDS cases that develop after transfusion.
authors.affiliation: Department of Laboratory Medicine, University of California at San Francisco, San Francisco, California.
authors.forename: Pearl
authors.initials: P
authors.lastname: Toy
authors.affiliation: Department of Pathology, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Steven H
authors.initials: SH
authors.lastname: Kleinman
authors.affiliation: Departments of Medicine and Laboratory Medicine, University of California at San Francisco, San Francisco, California.
authors.forename: Mark R
authors.initials: MR
authors.lastname: Looney
mesh_terms: D055371:Acute Lung Injury / Q000097:blood / Q000145:classification; D006801:Humans; D012128:Respiratory Distress Syndrome / Q000097:blood / Q000145:classification; D012307:Risk Factors; D065227:Transfusion Reaction / Q000097:blood / Q000145:classification