hematology and oncology
Complications of Transfusion
Transfusion related acute lung injury (TRALI)
Transfusion-related acute lung injury is an infrequent complication caused by anti-HLA and/or antigranulocyte antibodies in donor plasma that agglutinate and degranulate recipient granulocytes within the lung. Acute respiratory symptoms develop, and chest x-ray has a characteristic pattern of noncardiogenic pulmonary edema. This complication is the second most common cause of transfusion-related death. Incidence is 1 in 5,000 to 1 in 10,000 transfusions, but many cases are mild. Mild to moderate transfusion-related acute lung injury probably is commonly missed. General supportive therapy typically leads to recovery without long-lasting sequelae. Diuretics should be avoided. Using blood donated by men reduces the risk of this reaction. Cases should be reported to the hospital transfusion medicine service or blood bank. 