What is TRALI?

A blood transfusion is a serious medical procedure that comes with risks that may be life threatening. One of those risks is a condition that is known as TRALI. This occurs when there is a buildup of fluid in the lungs after a transfusion. This usually results in difficulty breathing that normally requires medical intervention.

Transfusion related acute lung injury or TRALI is a serious medical condition that occurs in some cases following a blood transfusion. In order to be considered to be a case of TRALI they symptoms must occur within six hours of a blood transfusion. The symptoms of the condition are that fluids will build up in the lungs making it difficult to breathe. In all cases medical treatment will be necessary in order to allow the patient to regain normal breathing. Often this will involve mechanical ventilation so the condition can be quite serious.

It is not exactly clear what causes TRALI, although it does appear that the components of the plasma the likely cause. This would include things like platelets but it could be from other things in the plasma as well. There is also some evidence that multiple transfusions will increase sensitivity making TRALI more likely. Currently the best theory on how the condition forms is that it is caused by antibodies called HLA. The belief is that these antibodies are released in response to whatever it is in the plasma because it is a foreign substance that is viewed as a threat. There are tests that can be conducted to determine the likelihood that of these antibodies being released but since nobody is entirely sure that this is the cause it may or may not help with diagnosing the condition.

One issue with TRALI is that it is not clear just how common the condition is. Officially there are an average of six deaths a year in the US because of it. Most experts believe that this number is a serious underestimate and that the number is closer to two hundred. The reason for this discrepancy is that many cases as are actually reported as being something else. Regardless of what the actual number is it is a risk that needs to be addressed if you need a blood transfusion.

One of the potential solutions to the problem of TRALI is to improve the quality of blood products that are used in transfusions. There is evidence to show that blood that is donated by females who have had multiple children is more likely to produce the antibodies that causes the condition. As a result it is now being recommended that blood banks not use blood from female donors for transfusions but rather use it for manufacturing blood products. It is the hoped that this will reduce the likelihood of TRALI occurring.