TRANSFUSION RELATED ACUTE LUNG INJURY

Rabia Sultana, *Dr. Sattwik Das and Dr. Beduin Mahanti

ABSTRACT

Transfusion Related Acute Injury (TRALI) represent Acute Lung Injury(ALI) after transfusion of one or more plasma-containing blood plasma developing within 6 hours of transfusion ,not explained by another ALI factor. The mechanisms are still unclear. In massive transfusion, the mechanism of lung injury was initially thought to be microaggregates in stored blood causing micro-pulmonary emboli and lung damage, but this theory has been discredited, since transfusion of stored blood through microaggregate filters has not prevented lung injury in animals nor in humans. Pathologically, the disease involves sequestration of activated neutrophils within the pulmonary capillaries, leading to acute lung injury. 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.

Keywords: Transfusion related acute lung injury (TRALI), Blood transfusion, Acute Lung Injury.