Quick Notes on TRALI

Rare (0.04 to 0.1% of transfused patients) but fatal complication of transfusion

Plasma components and platelet concentrates historically highest risk, however mitigation strategies have reduced this. Now largest # TRALI deaths from PRBCs, see chart:

FY09:FFP:2;RBC:6;FP24:1;Platelets Pheresis:2;Pooled Platelets:0;Multiple Products:2
FDA: Incidence of TRALI Mortality


blood component
-plamsa / whole blood from Females
– increased HLA Class II ab with specificity for HLA antigen
-increased anti-HNA Ab
-NOT RBC storage duration

-liver transplant surgery
-chronic alcohol abuse
-high peak airway pressures during ventilation
-high IL-8 levels
-positive fluid balance


UpToDate: TRALI (last update July 2015)


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