Best Practice & Research Clinical Anaesthesiology
Volume 21, Issue 2 , Pages 183-193, June 2007

TRALI – Definition, mechanisms, incidence and clinical relevance

  • Pearl Toy, MD (Professor of Laboratory Medicine)

      Affiliations

    • Corresponding Author InformationCorresponding author. Tel.: +1 415 353 1671; Fax: +1 415 476 9815.
  • Clifford Lowell, MD, PhD (Chairman and Professor of Laboratory Medicine)

      Affiliations

    • Tel.: +1 415 476 2540; Fax: +1 415 502 6497.

University of California San Francisco, San Francisco, CA 94143-0100, USA

University of California San Francisco, San Francisco, CA 94143-0134, USA

Transfusion-related acute lung injury (TRALI) is defined as new acute lung injury (ALI) that occurs during or within six hours of transfusion, not explained by another ALI risk factor. Transfusion of part of one unit of any blood product can cause TRALI. The mechanism may include factors in unit(s) of blood, such as antibody and biologic response modifiers. In addition, yet to be described factors in a patient's illness may predispose to the condition. The current incidence is estimated to be 1 in 5,000 units. Patients present with acute dyspnea, or froth in the endotracheal tube in intubated patients. Hypertension, hypotension, acute leukopenia have been described. Management is similar to that for ALI and is predominantly supportive. When TRALI is suspected, Blood banks should be notified to quarantine other components from the same donation. No special blood product is required for subsequent transfusion of a patient who has developed TRALI.

Key words: blood transfusion/adverse effects, pulmonary edema, acute lung injury

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PII: S1521-6896(07)00003-1

doi:10.1016/j.bpa.2007.01.003

Best Practice & Research Clinical Anaesthesiology
Volume 21, Issue 2 , Pages 183-193, June 2007

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