Transfusion-related acute lung injury

Christopher C. Silliman, Daniel R. Ambruso, Lynn Boshkov

Research output: Contribution to journalArticle

300 Citations (Scopus)

Abstract

Transfusion-related acute lung injury (TRALI) is a life-threatening adverse effect of transfusion that is occurring at increasing incidence in the United States and that, in the past 2 reporting years, has been the leading cause of transfusion-related death. TRALI and acute lung injury (ALI) share a common clinical definition except that TRALI is temporally and mechanistically related to the transfusion of blood/blood components. In prospective studies, 2 patient groups, 1 requiring cardiac surgery and 1 with hematologic malignancies and undergoing induction chemotherapy, were predisposed. Two different etiologies have been proposed. The first is a single antibody-mediated event involving the transfusion of anti-HLA class I and class II or antigranulocyte antibodies into patients whose leukocytes express the cognate antigens. The second is a 2-event model: the first event is the clinical condition of the patient resulting in pulmonary endothelial activation and neutrophil sequestration, and the second event is the transfusion of a biologic response modifier (including lipids or antibodies) that activates these adherent polymorphonuclear leukocytes (PMNs), resulting in endothelial damage, capillary leak, and TRALI. These hypotheses are discussed, as are the animal models and human studies that provide the experimental and clinical relevance. Prevention, treatment, and a proposed definition of TBALI, especially in the context of ALI, are also examined.

Original languageEnglish (US)
Pages (from-to)2266-2273
Number of pages8
JournalBlood
Volume105
Issue number6
DOIs
StatePublished - Mar 15 2005
Externally publishedYes

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Acute Lung Injury
Antibodies
Blood
Chemotherapy
Surgery
Animals
Chemical activation
Lipids
Antigens
Neutrophil Activation
Induction Chemotherapy
Hematologic Neoplasms
Blood Transfusion
Thoracic Surgery
Neutrophils
Leukocytes
Animal Models
Prospective Studies
Lung
Incidence

ASJC Scopus subject areas

  • Hematology

Cite this

Silliman, C. C., Ambruso, D. R., & Boshkov, L. (2005). Transfusion-related acute lung injury. Blood, 105(6), 2266-2273. https://doi.org/10.1182/blood-2004-07-2929

Transfusion-related acute lung injury. / Silliman, Christopher C.; Ambruso, Daniel R.; Boshkov, Lynn.

In: Blood, Vol. 105, No. 6, 15.03.2005, p. 2266-2273.

Research output: Contribution to journalArticle

Silliman, CC, Ambruso, DR & Boshkov, L 2005, 'Transfusion-related acute lung injury', Blood, vol. 105, no. 6, pp. 2266-2273. https://doi.org/10.1182/blood-2004-07-2929
Silliman CC, Ambruso DR, Boshkov L. Transfusion-related acute lung injury. Blood. 2005 Mar 15;105(6):2266-2273. https://doi.org/10.1182/blood-2004-07-2929
Silliman, Christopher C. ; Ambruso, Daniel R. ; Boshkov, Lynn. / Transfusion-related acute lung injury. In: Blood. 2005 ; Vol. 105, No. 6. pp. 2266-2273.
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