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Blood, 15 March 2005, Vol. 105, No. 6, pp. 2266-2273. Prepublished online as a Blood First Edition Paper on November 30, 2004; DOI 10.1182/blood-2004-07-2929. This Article Full Text Full Text (PDF) All Versions of this Article: 2004-07-2929v1 105/6/2266    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Silliman, C. C. Articles by Boshkov, L. K. Search for Related Content PubMed PubMed Citation Articles by Silliman, C. C. Articles by Boshkov, L. K. Related Collections Transfusion Medicine Free Research Articles Review Articles Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  REVIEW ARTICLES Transfusion-related acute lung injury Christopher C. Silliman, Daniel R. Ambruso, and Lynn K. Boshkov From the Bonfils Blood Center and the Departments of Pediatrics and Surgery, University of Colorado School of Medicine, Denver, CO; and the Department of Pathology, Oregon Health and Sciences University, Portland, OR. Transfusion-related acute lung injury (TRALI) is a life-threatening adverse effect of transfusion that is occurring at increasing incidence in the United States and that, in the past 2 reporting years, has been the leading cause of transfusion-related death. TRALI and acute lung injury (ALI) share a common clinical definition except that TRALI is temporally and mechanistically related to the transfusion of blood/blood components. In prospective studies, 2 patient groups, 1 requiring cardiac surgery and 1 with hematologic malignancies and undergoing induction chemotherapy, were predisposed. Two different etiologies have been proposed. The first is a single antibody-mediated event involving the transfusion of anti-HLA class I and class II or antigranulocyte antibodies into patients whose leukocytes express the cognate antigens. The second is a 2-event model: the first event is the clinical condition of the patient resulting in pulmonary endothelial activation and neutrophil sequestration, and the second event is the transfusion of a biologic response modifier (including lipids or antibodies) that activates these adherent polymorphonuclear leukocytes (PMNs), resulting in endothelial damage, capillary leak, and TRALI. These hypotheses are discussed, as are the animal models and human studies that provide the experimental and clinical relevance. Prevention, treatment, and a proposed definition of TRALI, especially in the context of ALI, are also examined. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: J. W. Adamson New Blood, Old Blood, or No Blood? N. Engl. J. Med., March 20, 2008; 358(12): 1295 - 1296. [Full Text] [PDF] R. S. Jawa, S. Anillo, and M. N. Kulaylat Transfusion-Related Acute Lung Injury J Intensive Care Med, March 1, 2008; 23(2): 109 - 121. [Abstract] [PDF] J. H. Levy and N. F. Adkinson Jr Anaphylaxis During Cardiac Surgery: Implications for Clinicians Anesth. Analg., February 1, 2008; 106(2): 392 - 403. [Abstract] [Full Text] [PDF] D. G. Ririe, P. E. Lantz, S. S. Glazier, and L. C. Argenta Transfusion-Related Acute Lung Injury in an Infant During Craniofacial Surgery Anesth. Analg., October 1, 2005; 101(4): 1003 - 1006. [Abstract] [Full Text] [PDF]

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