Title:Prevention of Non-immune Mediated Transfusion-related Acute Lung Injury; from Blood Bank to Patient
Volume: 18
Issue: 22
Author(s): Robin van Bruggen and Dirk de Korte
Affiliation:
Keywords:
Transfusion, TRALI, Storage lesion, Bioactive lipids, sCD40L, LysoPC, Non-immune, anti-leukocyte antibodies, blood products, blood banking procedures
Abstract: Transfusion-related acute lung injury (TRALI) is a severe form of pulmonary insufficiency induced by transfusion. TRALI is
the leading cause of transfusion-related death, and is caused by the infusion of either anti-leukocyte antibodies in plasma containing
blood products or neutrophil priming substances that accumulate during storage of cellular blood products. Among these neutrophil priming
substances are bioactive lipids, such as lyso-phosphatidylcholines (lysoPCs) and arachidonic acid, soluble CD40L (sCD40L) and possibly
other, as yet unidentified substances. The accumulation of these substances during cellular blood product storage and their role in
the induction of “non-immune mediated” TRALI pathogenesis are highly relevant for the current debate of the use of longer vs. shorter
stored blood products. In this review, the accumulation of these different substances during storage, as well as their mode of action in inducing
TRALI are discussed. In addition, different improvements in current blood banking procedures to prevent TRALI due to these
non-immune mediators will be proposed.
