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Recurrent transfusion‐related acute lung injury after a two‐year interval
Author(s) -
Krochmal J. D.,
Dwyre D. M.,
Swanson K. M.,
Raife T. J.,
Schlueter A. J.
Publication year - 2007
Publication title -
transfusion medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.471
H-Index - 59
eISSN - 1365-3148
pISSN - 0958-7578
DOI - 10.1111/j.1365-3148.2007.00730.x
Subject(s) - medicine , transfusion related acute lung injury , human leukocyte antigen , fresh frozen plasma , blood transfusion , complication , cirrhosis , liver transplantation , pneumonia , transplantation , immunology , lung , antigen , platelet , pulmonary edema
summary Transfusion‐related acute lung injury (TRALI) is a life‐threatening complication of blood transfusion. The epidemiology and pathogenesis of TRALI are not well established. A Medline literature search shows only rare reports of recurrent TRALI, all occurring soon after the first episodes. We report a case of recurrent TRALI after a 2‐year interval. A patient developed TRALI after transfusion of 4 units of fresh frozen plasma for gastrointestinal bleeding due to oesophageal varices in September 2002. The patient required mechanical ventilation but recovered completely. Two years later, in October 2004, the patient experienced a second episode of TRALI during liver transplantation for hepatitis C virus /alcoholic cirrhosis. Again, the patient recovered after ventilator support. Laboratory investigation of the first TRALI episode (2002) showed antibodies against class II human leukocyte antigens (HLA) in three female donors. Laboratory investigation of the second episode (2004) showed anti‐DR52 (HLA class II) antibodies in one female donor matching the DR‐52 HLA class II antigen in the recipient. TRALI can rarely recur. Consideration of future blood needs for patients experiencing recurrent TRALI should include preventive measures against further TRALI reactions, such as blood from male donors or blood less than 14 days old.