Transfusion-related acute lung injury (TRALI) in two thalassaemia patients caused by the same multiparous blood donor
Main Article Content
Keywords
Thalassemic Syndromes, Anemia, TRALI
Abstract
Two separate episodes of transfusion-related acute lung injury (TRALI) in thalassaemia patients caused by red blood cell transfusions from the same multiparous blood donor are reported. Both cases had the same symptomatology and occurred 10-60 minutes of transfusion. The patients presented dyspnea, sweating, fatigue, dizziness, fever, and sense of losing consciousness. The chest x-ray showed a pulmonary oedema-like picture with both lungs filled with fluid. The patients were treated in the intensive therapy unit. They were weaned off the ventilator and discharged following hospitalization 7 and 9 days respectively. The TRALI syndrome was diagnosed to be associated with HLA-specific donor antibodies against mismatched HLA-antigens of the transfused patients. Haemovigilance improvements are essential for reducing the morbidity and mortality in transfused patients. Blood from multiparous donors should be tested for the presence of IgG HLA-Class I and –Class II antibodies before being transfused in thalassaemia and other chronically transfused patients.
Downloads
Abstract 1661
PDF Downloads 535
HTML Downloads 788
References
2] Teofili L, Bianchi M, Zanfini BA, Catarci S, Sicuranza R, Spartano S et al. Acute lung injury complicating blood transfusion in post-partum hemorrhage: incidence and risk factors. Mediterr J Hematol Infect Dis. 2014;6:e2014069.
3] Peters AL, Van Stein D, Vlaar AP. Antibody-mediated transfusion-related acute lung injury; from discovery to prevention. Br J Haematol. 2015;170:597-614.
4] Moalic V, Vaillant C, Ferec C. Transfusion related acute lung injury (TRALI): an unrecognised pathology. Pathol Biol (Paris). 2005;53:111-115.
5] Bulanov AIu. Transfusion-associated lung injury (TRALI): obvious and incomprehensible. Anesteziol Reanimatol. 2009;5:48-52.
6] Porretti L, Cattaneo A, Coluccio E, Mantione E, Colombo F, Mariani M. Implementation and outcomes of a transfusion-related acute lung injury surveillance programme and study of HLA/HNA alloimmunisation in blood donors. Blood Transfus. 2012;10:351-359.
7] M?ller MC, Porcelijn L, Vlaar AP. Prevention of immune-mediated transfusion-related acute lung injury; from bloodbank to patient. Curr Pharm Des. 2012; 18: 3241-3248.
8] Keller-Stanislawski B, Reil A, Günay S, Funk MB. Frequency and severity of transfusion-related acute lung injury- German haemovigilance data (2006-2007). Vox Sang. 2010;98:70-77.
9] Singer ST, Wu V, Mignacca R, Kuypers FA, Morel P, Vichinsky EP. Alloimmunization and erythrocyte autoimmunization in transfusion-dependent thalassemia patients of predominantly asian descent. Blood. 2000;96:3369-3373.
10] Chaudhari CN. Red Cell Alloantibodies in multiple transfused thalassaemia patients . MJAFI 2011; 67: 34-37.
11] Kolnagou A, Kontoghiorghe CN, Kontoghiorghes GJ. Transition of Thalassaemia and Friedreich ataxia from fatal to chronic diseases. World J Methodol. 2014;4:197-218.
12] Prati D. Benefits and complications of regular blood transfusion in patients with beta-thalassaemia major. Vox Sang.2000;79:129-137.
13] Silliman CC, Boshkov LK, Mehdizadehkashi Z, Elzi DJ, Dickey WO, Podlosky L et al. Transfusion-related acute lung injury: epidemiology and a prospective analysis of etiologic factors. Blood. 2003;101: 454-462.
14] Lucas G, Win N, Calvert A, Green A, Griffin E, Bendukidze N,et al.Reducing the incidence of TRALI in the UK: the results of screening for donor leucocyte antibodies and the development of national guidelines.Vox Sang. 2012;103:10-17.