Low‐risk transfusion‐related acute lung injury donor strategies and the impact on the onset of transfusion‐related acute lung injury: a meta‐analysis

Background Transfusion‐related acute lung injury ( TRALI ) is the leading cause of transfusion‐related mortality. In the past decade blood banks have implemented low‐risk TRALI donor strategies, including a male‐only donor policy for plasma‐containing blood products to prevent onset of TRALI . We performed a meta‐analysis to determine whether use of low‐risk TRALI donor strategies for plasma indeed reduces onset of TRALI . Study Design and Methods We searched MEDLINE and C ochrane C entral R egister of C ontrolled T rials from J anuary 1995 up to J anuary 2013. Two reviewers independently extracted data on study characteristics, methods, and outcomes. Primary endpoint was onset of TRALI . Subgroup analyses were performed for patient populations prone to develop TRALI and general patient populations. Results Ten articles were included. Meta‐analysis using a random‐effects model taking into account all transfused products showed a significant reduction for the risk of TRALI after implementation of low‐risk TRALI donor strategies (odds ratio [ OR ], 0.61; 95% confidence interval [ CI ], 0.42‐0.88). Data from patient populations prone to develop TRALI showed a significant reduction of TRALI risk ( OR , 0.51; 95% CI , 0.29‐0.90), while data from general patient populations showed a similar nonsignificant trend ( OR , 0.66; 95% CI , 0.40‐1.09). Results were similar when taking only plasma products into account ( OR , 0.62; 95% CI , 0.42‐0.92). Conclusion The introduction of low‐risk TRALI donor strategies for plasma‐containing products results in a reduction of TRALI .