Korean J Blood Transfus.  2019 Dec;30(3):219-229. 10.17945/kjbt.2019.30.3.219.

Case Series of Transfusion-Related Acute Lung Injury in a Tertiary Hospital and a Practical Comparison with the New Diagnostic Criteria

Affiliations
  • 1Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea. sykim@yuhs.ac

Abstract

BACKGROUND
Transfusion-related acute lung injury (TRALI) is defined as acute respiratory distress syndrome with non-cardiogenic pulmonary edema caused by transfusion. It occurs only rarely but could result in patient mortality. TRALI has been declining since the successful adoption of TRALI risk mitigation strategies in several countries. The new diagnostic criteria were suggested in 2019 based on the knowledge and experience gained throughout the last decade. This article integrated a series of TRALI cases diagnosed in a tertiary hospital while reviewing each case based upon the new diagnostic criteria.
METHODS
Among the reported transfusion adverse reactions that occurred from March 2013 to June 2019, seven TRALI cases were recruited for this study. Each case was retrospectively reexamined with its clinical condition and transfusion history. The diagnosed cases were classified into TRALI subtypes newly suggested in the 2019 version.
RESULTS
The mean time interval to adverse reaction was 117 minutes (range: 7~370 minutes) and all satisfied the condition of hypoxemia and bilateral pulmonary infiltrations. The transfused blood components were apheresis platelets in three cases, platelet concentrates in one case, red blood cells in one case and combinations of different products in two cases. Five cases were diagnosed as possible TRALI, and all five cases were diagnosed as TRALI type 2 (2019 criteria).
CONCLUSION
In our center, seven patients were diagnosed TRALI during the last 6 years. Screening more TRALI patients according to the new criteria, along with investigating the patients' clinical characteristics, transfused blood components, treatments and integrated research, will facilitate Korean research on this field of medicine.

Keyword

Transfusion adverse reaction; Transfusion-related acute lung injury; Diagnostic criteria

MeSH Terms

Acute Lung Injury*
Anoxia
Blood Component Removal
Blood Platelets
Erythrocytes
Humans
Mass Screening
Mortality
Pulmonary Edema
Respiratory Distress Syndrome, Adult
Retrospective Studies
Tertiary Care Centers*
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