PMID- 18257817
OWN - NLM
STAT- MEDLINE
DCOM- 20080422
LR  - 20081121
IS  - 1744-9987 (Electronic)
IS  - 1744-9979 (Linking)
VI  - 12
IP  - 1
DP  - 2008 Feb
TI  - A case report of transfusion-related acute lung injury during plasma exchange 
      therapy for thrombotic thrombocytopenia purpura.
PG  - 78-81
LID - 10.1111/j.1744-9987.2007.00545.x [doi]
AB  - Transfusion-related acute lung injury (TRALI) is a transfusion reaction that is 
      often under recognized and underreported. Implications for diagnosis not only 
      influence treatment considerations but also extend to donor selection, donor 
      deferral and ultimately the safety of the final blood product. We report a case 
      of a previously well 19-year-old female who presented a one week history of 
      flu-like symptoms and mucosal bleeding. Laboratory results confirmed the 
      diagnosis of thrombotic thrombocytopaenia purpura (TTP) and she was commenced on 
      plasma exchange. During her second day of plasma exchange, she developed dyspnoea 
      and rigors. Examination and investigation findings were consistent with a 
      clinical diagnosis of TRALI. Granulocytes immunofluorescent test (GIFT - flow 
      cytometry) was performed and cross reactivity was demonstrated between the 
      patient's granulocytes and plasma from one of the nine donor fresh frozen plasma 
      (FFP) packs. She made a full recovery. TRALIa accounts for 7% of all adverse 
      events reported in the Serious Hazards of Transfusion (SHOT) database and has a 
      mortality rate between 5-25%. Apheresis patients are a particularly vulnerable 
      group of patients where clinical recognition and rapid laboratory confirmation of 
      TRALI is imperative to minimize the risk of further patient exposure to donor 
      granulocyte or human leukocyte antigen (HLA) antibodies. The provision of plasma 
      from male donors may additionally reduce exposure. On a wider scale, rapid donor 
      identification and deferral maintains the safety of the national blood supply.
FAU - P'ng, Stephanie S Y
AU  - P'ng SS
AD  - Department of Haematology, Royal Perth Hospital, Perth, WA, Australia.
FAU - Hughes, Annette S
AU  - Hughes AS
FAU - Cooney, Julian P
AU  - Cooney JP
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - Australia
TA  - Ther Apher Dial
JT  - Therapeutic apheresis and dialysis : official peer-reviewed journal of the 
      International Society for Apheresis, the Japanese Society for Apheresis, the 
      Japanese Society for Dialysis Therapy
JID - 101181252
SB  - IM
MH  - Acute Disease
MH  - Adult
MH  - Cross Reactions
MH  - Female
MH  - Flow Cytometry
MH  - Fluorescent Antibody Technique
MH  - Granulocytes
MH  - Humans
MH  - Lung/pathology
MH  - *Lung Injury
MH  - Plasma Exchange/*adverse effects
MH  - Purpura, Thrombotic Thrombocytopenic/*therapy
EDAT- 2008/02/09 09:00
MHDA- 2008/04/23 09:00
CRDT- 2008/02/09 09:00
PHST- 2008/02/09 09:00 [pubmed]
PHST- 2008/04/23 09:00 [medline]
PHST- 2008/02/09 09:00 [entrez]
AID - TAP545 [pii]
AID - 10.1111/j.1744-9987.2007.00545.x [doi]
PST - ppublish
SO  - Ther Apher Dial. 2008 Feb;12(1):78-81. doi: 10.1111/j.1744-9987.2007.00545.x.