Document Detail

Transfusion-related acute lung injury surveillance (2003-2005) and the potential impact of the selective use of plasma from male donors in the American Red Cross.
MedLine Citation:
PMID:  17381617     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: American Red Cross surveillance data on transfusion-related acute lung injury (TRALI) fatalities were analyzed to evaluate the association with components from donors with white blood cell (WBC) antibodies and to examine the potential impact of the selective transfusion of plasma from male donors. STUDY DESIGN AND METHODS: Suspected TRALI reports in 2003 through 2005 were identified and all fatalities were reviewed and classified by three physicians as "probable TRALI" or of "unrelated etiology," with independent review of the associated serologic investigation. Hospital investigational and reporting biases could not be fully controlled in this retrospective study. RESULTS: A total of 550 reports of suspected TRALI, including 72 fatalities, were investigated. The number of reports increased each year and the rate varied by geographic region. Retrospective review of fatalities revealed 38 cases of probable TRALI, the majority (24 of 38 [63%]) after plasma transfusion. A female, WBC antibody-positive donor was involved in 71 percent (27 of 38) of cases and in 75 percent (18 of 24) of cases involving plasma transfusion. Female antibody-positive donors were more likely to be associated with probable TRALI than with unrelated cases (p = 0.0001; odds ratio [OR], 9.5; 95% confidence interval [CI], 2.9-31.1]. The rate of probable TRALI among recipient fatalities was higher for plasma components (1:202,673; OR, 12.5; 95% CI, 5.4-28.9) and apheresis platelets (PLTs; 1:320,572; OR, 7.9; 95% CI, 2.5-24.8) compared to red cells (1:2,527,437). Male donors contributed 64.5 and 52.0 percent of distributed apheresis PLTs and plasma components, respectively, in 2005. CONCLUSION: Plasma components linked to female donors with WBC antibodies were responsible for the majority of probable TRALI fatalities. Prudent measures to limit transfusion of WBC antibody-containing plasma components may prevent as many as six fatalities per year in the Red Cross system.
Anne F Eder; Ross Herron; Annie Strupp; Beth Dy; Edward P Notari; Linda A Chambers; Roger Y Dodd; Richard J Benjamin
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Transfusion     Volume:  47     ISSN:  0041-1132     ISO Abbreviation:  Transfusion     Publication Date:  2007 Apr 
Date Detail:
Created Date:  2007-03-26     Completed Date:  2007-09-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0417360     Medline TA:  Transfusion     Country:  United States    
Other Details:
Languages:  eng     Pagination:  599-607     Citation Subset:  IM    
Biomedical Services, National Headquarters, American Red Cross, Washington, DC 20006, USA.
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MeSH Terms
Aged, 80 and over
Blood Component Transfusion / adverse effects,  statistics & numerical data
Blood Donors
Blood Transfusion / adverse effects*,  statistics & numerical data
Histocompatibility Testing
Middle Aged
Red Cross*
Respiratory Distress Syndrome, Adult / etiology*,  mortality,  prevention & control
Retrospective Studies
Risk Management / methods,  standards
Sex Factors
Survival Rate
United States
Comment In:
Transfusion. 2007 Apr;47(4):563-4   [PMID:  17381611 ]
Transfusion. 2007 Apr;47(4):559-62   [PMID:  17381610 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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