LQCL2416 - CMLE - A Recent Death: Cause of Death Possible TRALI-A Recent Death: Cause of Death Possible TRALI

A Recent Death: Cause of Death Possible TRALI

Pdf Summary

Transfusion-related acute lung injury (TRALI) is a severe complication of blood transfusions caused by leukocyte antibodies in donor plasma, resulting in acute lung injury. This case study describes a patient with breast cancer who developed severe pancytopenia and required multiple platelet and PRBC transfusions, subsequently experiencing symptoms leading to TRALI. TRALI, a recognized cause of transfusion-related fatalities, has a mortality rate of 6-10%. Efforts to mitigate TRALI risk include excluding female donors, screening donors for HNA and HLA antibodies, and using leukoreduced blood products. Patients suspected of TRALI should have transfusions halted, and the blood bank and attending physician notified. Diagnosis involves identifying HLA and HNA antibodies in donor plasma. Management includes initiating appropriate oxygenation and distinguishing TRALI from other transfusion reactions. This case exemplifies the 2-hit model of TRALI and underscores the importance of prompt recognition and reporting of transfusion reactions. Adhering to recommendations to minimize TRALI risk and enhance patient safety in transfusion settings can significantly impact patient outcomes and prevent fatal consequences of TRALI.

Keywords

Transfusion-related acute lung injury

TRALI

Leukocyte antibodies

Donor plasma

Acute lung injury

Breast cancer

Pancytopenia

Platelet transfusions

PRBC transfusions

HLA antibodies