PMID- 12393667
OWN - NLM
STAT- MEDLINE
DCOM- 20030408
LR  - 20210206
IS  - 0006-4971 (Print)
IS  - 0006-4971 (Linking)
VI  - 101
IP  - 2
DP  - 2003 Jan 15
TI  - Transfusion-related acute lung injury: epidemiology and a prospective analysis of 
      etiologic factors.
PG  - 454-62
AB  - Transfusion-related acute lung injury (TRALI) is a life-threatening complication 
      of hemotherapy. We report a series of 90 TRALI reactions in 81 patients secondary 
      to transfusion with whole blood platelets (72 reactions), apheresis platelets 
      (2), packed red cells (15), and plasma (1). The overall prevalence was 1 in 1120 
      cellular components. To examine the epidemiology of TRALI, we completed a nested 
      case-control study of the first 46 patients with TRALI compared with 225 controls 
      who had received transfusions. We then completed a prospective analysis of 
      possible biologic response modifiers responsible for 51 of the TRALI cases, 
      including human leukocyte antigen (HLA) class I, class II, and granulocyte 
      antibodies in donors and neutrophil (PMN) priming activity in the plasma of the 
      implicated units and recipients. Two groups were at risk: patients with 
      hematologic malignancies (P <.0004) and patients with cardiac disease (P <.0006). 
      TRALI was associated with older platelets (P =.014). In the prospective study, 
      antileukocyte antibodies were found in only 3.6% of cases. The implicated blood 
      components had greater PMN priming activity than controls (P <.05), and compared 
      with pretransfusion samples, TRALI patients' plasma demonstrated increases in 
      both interleukin 6 (IL-6) and lipid (neutral lipids and lysophosphatidylcholines) 
      priming activity (P <.05). We conclude that TRALI may be more frequent than 
      previously recognized and that patient susceptibility, product age, and increased 
      levels of bioactive lipids in components may predispose patients to TRALI. TRALI, 
      like the acute respiratory distress syndrome, may be a 2-event phenomenon with 
      both recipient predisposition and factors in the stored units playing major 
      roles.
FAU - Silliman, Christopher C
AU  - Silliman CC
AD  - Bonfils Blood Center and the Department of Pediatrics, University of Colorado 
      School of Medicine, Denver, USA.
FAU - Boshkov, Lynn K
AU  - Boshkov LK
FAU - Mehdizadehkashi, Zahra
AU  - Mehdizadehkashi Z
FAU - Elzi, David J
AU  - Elzi DJ
FAU - Dickey, William O
AU  - Dickey WO
FAU - Podlosky, Linda
AU  - Podlosky L
FAU - Clarke, Gwen
AU  - Clarke G
FAU - Ambruso, Daniel R
AU  - Ambruso DR
LA  - eng
GR  - HL59355/HL/NHLBI NIH HHS/United States
GR  - K07-HL02036/HL/NHLBI NIH HHS/United States
GR  - M01-RR00069/RR/NCRR NIH HHS/United States
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, P.H.S.
DEP - 20020905
PL  - United States
TA  - Blood
JT  - Blood
JID - 7603509
RN  - 0 (HLA Antigens)
RN  - 0 (Immunologic Factors)
RN  - 0 (Isoantibodies)
RN  - 0 (Isoantigens)
RN  - 59880-97-6 (N-Formylmethionine Leucyl-Phenylalanine)
SB  - IM
MH  - Age Distribution
MH  - Case-Control Studies
MH  - Granulocytes
MH  - HLA Antigens/immunology
MH  - Humans
MH  - Immunologic Factors/blood
MH  - Isoantibodies/blood
MH  - Isoantigens/immunology
MH  - N-Formylmethionine Leucyl-Phenylalanine/pharmacology
MH  - Neutrophils/drug effects
MH  - Prospective Studies
MH  - Respiratory Distress Syndrome/epidemiology/*etiology
MH  - Risk Assessment
MH  - *Transfusion Reaction
EDAT- 2002/10/24 04:00
MHDA- 2003/04/09 05:00
CRDT- 2002/10/24 04:00
PHST- 2002/10/24 04:00 [pubmed]
PHST- 2003/04/09 05:00 [medline]
PHST- 2002/10/24 04:00 [entrez]
AID - S0006-4971(20)44498-2 [pii]
AID - 10.1182/blood-2002-03-0958 [doi]
PST - ppublish
SO  - Blood. 2003 Jan 15;101(2):454-62. doi: 10.1182/blood-2002-03-0958. Epub 2002 Sep 
      5.