Title:Coagulopathy as a Therapeutic Target for TRALI: Rationale and Possible Sites of Action
Volume: 18
Issue: 22
Author(s): Pieter R. Tuinman, Marcus J. Schultz and Nicole P. Juffermans
Affiliation:
Keywords:
TRALI, platelets, acetylsalicylic acid, coagulation, fibrinolysis, ALI, therapy, fibrin turnover, pulmonary coagulopathy, anticoagulant interventions
Abstract: Transfusion-related acute lung injury (TRALI) is a subcategory of acute lung injury (ALI). As such, there are many similarities
between the syndromes, both clinically and pathophysiologically. Pulmonary changes in fibrin turnover have emerged as a hallmark
of ALI, thereby initiating studies investigating the potential of therapeutic interventions aimed at ameliorating this so-called pulmonary
coagulopathy. Enhanced coagulation and impaired fibrinolysis are probably also important features of TRALI. In particular, platelets
play an important role in mediating injury during a TRALI reaction. In this narrative review, the evidence of the role of coagulopathy and
platelet activation in TRALI is discussed. Given that host risk factors for acquiring TRALI have been identified and that there is a time
frame in which a preventive strategy in patients at risk for TRALI can be executed, preventive strategies are suggested. In this review, we
discuss potential preventive anticoagulant interventions.
