Document Detail


The pathogenesis of transfusion-related acute lung injury (TRALI).
MedLine Citation:
PMID:  17341264     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In recent years, transfusion-related acute lung injury (TRALI) has developed from an almost unknown transfusion reaction to the most common cause of transfusion-related major morbidities and fatalities. A clinical definition of TRALI was established in 2004, based on acute respiratory distress, non-cardiogenic lung oedema temporal association with transfusion and hypoxaemia. Histological findings reveal lung oedema, capillary leucostasis and neutrophil extravasation. However, the pathogenesis of TRALI remains controversial. Leucocyte antibodies, present in fresh frozen plasma and platelet concentrates from multiparous donors, and neutrophil priming agents released in stored cellular blood components have been considered to be causative. As neutrophils and endothelial cells are pivotal in the pathogenesis of TRALI, a threshold model was established to try to unify the various reported findings on pathogenesis. This model comprises the priming of neutrophils and/or endothelium by the patient's co-morbidity, neutrophil and/or endothelial cell activation by the transfused blood component, and the severity of the TRALI reaction.
Authors:
Jürgen Bux; Ulrich J H Sachs
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  British journal of haematology     Volume:  136     ISSN:  0007-1048     ISO Abbreviation:  Br. J. Haematol.     Publication Date:  2007 Mar 
Date Detail:
Created Date:  2007-03-07     Completed Date:  2007-04-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372544     Medline TA:  Br J Haematol     Country:  England    
Other Details:
Languages:  eng     Pagination:  788-99     Citation Subset:  IM    
Affiliation:
DRK-Blood Service West of the German Red Cross, Hagen, Germany. j.bux@bsdwest.de
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MeSH Terms
Descriptor/Qualifier:
Anoxia / complications
Antibodies / blood
Blood Component Transfusion / adverse effects
Blood Transfusion / adverse effects*
Humans
Isoantibodies / blood
Isoantigens / immunology
Lung / blood supply
Neutrophil Infiltration
Neutrophils / immunology
Pulmonary Edema / etiology*,  immunology
Respiratory Distress Syndrome, Adult / etiology*,  immunology
Syndrome
Transplantation Immunology
Chemical
Reg. No./Substance:
0/Antibodies; 0/Isoantibodies; 0/Isoantigens

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


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