TRALI

Thursday August 17, 2006
TRALI

Transfusion-Related Acute Lung Injury (TRALI) - a different condition from transfusion related pulmonary edema - has an incidence of approximately 1:5,000 units of blood transfused. Approximately 6% of the patients die from TRALI and 72% require mechanical ventilation. It typically occurs within 2 – 4 hours after infusion of blood product, although it can occur up to 40 hours following the transfusion. Most cases resolve spontaneously within 3 – 4 days and there are rarely long time sequelae.

The etiology of TRALI is incompletely understood. TRALI can occur after transfusion of packed RBCs, whole blood, platelets, fresh frozen plasma and cryoprecipitate.

Treatment is supportive, although high-dose steroids have been shown to be successful in old animal studies. In patients with documented TRALI, ideally, subsequent transfusions should be autologous, or in case of packed RBCs, washed to remove residual plasma.


Read review article: Transfusion-Related Acute Lung Injury - Ref: Mayo Clin Proc. 2005;80:766-770