T RALI

Adverse Effect of Transfusion Transfusion-related acute lung injury Mary Christelle G. Aquitania UST MedTech Intern January 2012
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Present during or within hours of transfusion Attributed:

Presence of Ab in plasma of transfused unit directed against HLA I / granulocyte Ag in recipient WBC (Kopko, 2002) 2001) of multiparous female donor (Palfi,

Plasma

Presence

of lipid inflammatory mediators that activate already primed recipient 7/5/12 neutrophils (from surgery, trauma,

TRALI

(Kleiman, 2004)

Revolves within 48 to 96 hours from onset (Popovsky, 1992) WBC count and platelet count decreases = 7/5/12 transfusion of

Circulatory overload Bacterial contamination Allergic reaction Acute respiratory distress syndrome (ARDS) Pulmonary embolism Pulmonary hemorrhage
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Bottom : Anteroposterior chest radiograph from the same patient 24 h later showing significant resolution of the alveolar infiltrates,

Top : Anteroposterior chest radiograph from a 35-yearold woman with who received 2 U of freshfrozen plasma and acquired TRALI. The patient has an endotracheal tube in place and has diffuse bilateral alveolar infiltrates and a normal cardiac silhouette. This is a characteristic radiograph appearance for severe ALI in TRALI.

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Supportive treatment
Discontinue

progress)

transfusion (if s/s are in

Blood bags: Consulted regarding evaluation of TRALI is indicated

Oxygen

Severe:

Mechanical ventilation required

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Thank you
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