ABSTRACT
This chapter focuses on transfusion-related acute lung injury (TRALI), which is a significant pulmonary complication that can follow transfusion of any blood component. The leading causes of transfusion-related mortality were haemolytic and septic transfusion reactions. Signs and symptoms include dyspnoea with acute onset of bilateral pulmonary oedema and severe hypoxia. TRALI has been associated with the transfusion of all plasma-containing blood components including whole blood, packed red blood cells, granulocytes collected by apheresis, platelet concentrates, apheresis platelets, fresh frozen plasma and cryoprecipitate. Two immunological triggers – the infusion of antibodies directed against cognate antigen in the recipient, and the infusion of biological response modifiers – have been implicated in the pathogenesis of TRALI. Antibodies can be formed as a result of exposure to foreign antigens through transfusion or transplantation. In the most general sense, biological response modifiers are generated by white blood cells and accumulate during storage of cellular blood components.
