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British Journal of Anaesthesia, 2003, Vol. 90, No. 5 573-576
© 2003 The Board of Management and Trustees of the British Journal of Anaesthesia

Editorial I

Transfusion-related acute lung injury (TRALI)—under-diagnosed and under-reported

J. P. Wallis1

1 Consultant Haematologist, Department of Haematology, Freeman Hospital, Newcastle upon Tyne NE7 7DN, UK. E-mail: jonathan.wallis@tfh.nuth.northy.nhs.uk

The first 150 words of the full text of this article appear below.

Transfusion-related acute lung injury (TRALI) is almost certainly under-diagnosed. Though first described in 1957,1 many clinicians are unaware of the condition or may not recognize transfusion as the cause when it occurs. TRALI describes a particular form of acute respiratory distress syndrome (ARDS) that occurs after transfusion and which is caused by antibodies in plasma of a single donor unit reacting with leucocyte antigens in the recipient.

The condition is characterized by the sudden onset of non-cardiogenic pulmonary oedema, often with marked systemic hypovolaemia and hypotension, occurring during or within a few hours of transfusion.2 Fever and rigours are reported, but may be absent or relatively mild. There is rapid onset of severe hypoxia, a chest radiograph typical of ARDS, and copious frothy yellow or pink fluid in the trachea.3 Diagnosis of TRALI depends on the exclusion of other causes of pulmonary oedema or ARDS. Laboratory findings may include unexpected . . . [Full Text of this Article]


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