01 October 2010
The divergent clinical presentations of transfusion-related acute lung injury illustrated by two case reports
Alexander P.J. VlaarABCDEF, Leendert PorcelijnBCDE, Ingeborgh H.M. van Rooijen-SchreursBE, Neubury Maxton LardyBCDE, Marie Jose KerstenBDE, Nicole P. JuffermansABCDEFMed Sci Monit 2010; 16(10): CS129-134 :: ID: 881185
Abstract
Background: Although the 2-event pathogenesis of transfusion-related (TR) acute lung injury (ALI) has been accepted as an explanatory model, case reports classically describe patients without other risk factors for ALI. Patients who exhibit another risk factor for the onset of ALI may be neglected as having TRALI, which contributes to underreporting.
Case Report: Two cases of TRALI are reported. The first case is a patient with a hematologic malignancy who experienced ALI within 1 hour after a transfusion of concentrated platelets (PLT), with no other risk factor for ALI present. The second case is a patient with severe sepsis with multiorgan failure who received multiple transfusions during a laparotomy and exhibited ALI perioperatively. The implicated blood components originated from female donors in both cases. Analysis of the plasma of the PLT donor in the first case revealed HLA class I and II antibodies directed against the patient’s antigen. Analysis of the plasma of the fresh-frozen plasma donor in the second case did not reveal antibodies using the techniques available at that time. However, after involvement of this donor in a TRALI reaction in another recipient, HLA II antibodies directed against the antigen of the recipient were detected in the newly available single antigen Luminex technique.
Conclusions: The 2 cases illustrate that TRALI can occur both in the absence and in the presence of another ALI risk factor. Awareness should be increased that all patients exhibiting ALI within 6 hours of a blood transfusion, including possible TRALI, should be reported to the blood bank.
Keywords: perioperative period, Plasma - immunology, HLA Antigens - immunology, Blood Transfusion - adverse effects, Blood Donors, Antibodies - immunology, Acute Lung Injury - physiopathology, Platelet Transfusion - adverse effects, Risk Factors, Time Factors
Editorial
01 April 2023 : Editorial
Editorial: Effective Direct-Acting Antiviral Treatments Support Global and National Programs to Eliminate Hepatitis CDOI: 10.12659/MSM.940519
Med Sci Monit 2023; 29:e940519
SARS-CoV-2/COVID-19
30 March 2023 : Clinical Research
An Online Survey on the Relationship Between Positive Coping and Post-Traumatic Stress Symptoms (PTSS) of M...Med Sci Monit In Press; DOI: 10.12659/MSM.939485
09 February 2023 : Clinical Research
Evaluation of Health-Related Quality of Life and Mental Health in 729 Medical Students in Indonesia During ...Med Sci Monit 2023; 29:e938892
19 January 2023 : Clinical Research
Determining the Impact of the COVID-19 Pandemic on Dental Care in the Serbian Adult Population: An Online Q...Med Sci Monit 2023; 29:e939238
27 December 2022 : Clinical Research
Effect of Physiotherapy to Correct Rounded Shoulder Posture in 30 Patients During the COVID-19 Pandemic in ...Med Sci Monit 2022; 28:e938926
In Press
30 Mar 2023 : Clinical Research
An Online Survey on the Relationship Between Positive Coping and Post-Traumatic Stress Symptoms (PTSS) of M...Med Sci Monit In Press; DOI: 10.12659/MSM.939485
30 Mar 2023 : Database Analysis
Global Research Trends and Hotspots in Lateral Epicondylitis During the Past 30 Years: A Bibliometric and V...Med Sci Monit In Press; DOI: 10.12659/MSM.939309
29 Mar 2023 : Laboratory Research
Preparation, Physicochemical Properties, and Structural Characterization of Resistant Starch-Aspirin-Loaded...Med Sci Monit In Press; DOI: 10.12659/MSM.939711
29 Mar 2023 : Database Analysis
Causes of Death in Neonates, Infants, Children, and Adolescents at the University Children’s Clinical Hospi...Med Sci Monit In Press; DOI: 10.12659/MSM.939915
Most Viewed Current Articles
13 Nov 2021 : Clinical Research
Acceptance of COVID-19 Vaccination and Its Associated Factors Among Cancer Patients Attending the Oncology ...DOI :10.12659/MSM.932788
Med Sci Monit 2021; 27:e932788
30 Dec 2021 : Clinical Research
Retrospective Study of Outcomes and Hospitalization Rates of Patients in Italy with a Confirmed Diagnosis o...DOI :10.12659/MSM.935379
Med Sci Monit 2021; 27:e935379
08 Mar 2022 : Review article
A Review of the Potential Roles of Antioxidant and Anti-Inflammatory Pharmacological Approaches for the Man...DOI :10.12659/MSM.936292
Med Sci Monit 2022; 28:e936292
01 Jan 2022 : Editorial
Editorial: Current Status of Oral Antiviral Drug Treatments for SARS-CoV-2 Infection in Non-Hospitalized Pa...DOI :10.12659/MSM.935952
Med Sci Monit 2022; 28:e935952