Transfusion related lung injury (TRALI)
= acute dyspnoea with hypoxia and bilateral pulmonary infiltrates during or within 6 hours of transfusion, not due to circulatory overload or other likely cause
– cause not very clear, but potentially antibodies to white cell antigens or other neutrophil priming agents
required by definition to diagnose TRALI:
– onset within 6 hours of transfusion
– bilateral infiltrates on CXR
Who is at risk?
– risk 7 times higher with plasma-rich components (eg FFP, platelets)
– patients who receive bloods products from female donors, with previously pregnant female donors as highest risk
– supportive – ventilation / inotropes for hypotension
– preferentially plasma from male donors used for FFP / platelets
All suspected reactions should be reported to the blood bank.