• Yves Ozier, Jean-Yves Muller, Paul-Michel Mertes, Philippe Renaudier, Philippe Aguilon, Nathalie Canivet, Patrick Fabrigli, Danielle Rebibo, Mahdi Tazerout, Catherine Trophilme, Béatrice Willaert, and Cyril Caldani.
• Université Paris Descartes, Service d'Anesthésie-Réanimation Chirurgicale, Hôpital Cochin, and Hémovigilance Centrale, Assistance Publique-Hôpitaux de Paris, Paris, France. yves.ozier@cch.aphp.fr
• Transfusion. 2011 Oct 1; 51 (10): 2102-10.

BackgroundTransfusion-related acute lung injury (TRALI) is a major cause of transfusion-related mortality and morbidity. Epidemiologic studies using data from national transfusion schemes can help achieve a better understanding of TRALI incidence.Study Design And MethodsA multidisciplinary working group analyzed TRALI cases extracted from the French Hemovigilance Network Database (2007-2008). All notified cases were reviewed for diagnosis. Those meeting the Canadian Consensus Conference criteria for TRALI were classified according to imputability to transfusion and clinical severity. Patient data (clinical characteristics, number and types of products transfused, and serology results) were obtained.ResultsThere were 62 TRALI cases and 23 possible TRALI cases during the 2-year period. An immune-mediated mechanism was identified in 30 of 50 TRALI cases with complete serology. TRALI was considered to be the cause of death in 7.1% of patients and might have contributed to death in an additional 9.4% of TRALI or possible TRALI patients. Occurrence ranked high in obstetrics (15%), after surgery (34%), and in hematologic malignancies (21%). Single-donor high-plasma-volume components were involved in half of the cases where the implicated blood product could be determined and carried the highest risk per component (1:31,000 for single-donor fresh-frozen plasma units and apheresis platelet [PLT] concentrates, and 1:173,000 for red blood cells). No incident could be definitively related to the transfusion of solvent/detergent-treated pooled plasma (>200,000 units transfused), nor to pooled PLT concentrates.ConclusionThe proportion of TRALI cases related to plasma-rich components was lower than previously described.© 2011 American Association of Blood Banks.

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