Medicine & USMLE


Transfusion Reactions
  1. Anaphylactic Transfusion Reactions
  2. Acute Hemolytic Transfusion Reaction
  3. Febrile Nonhemolytic Transfusion Reaction
  4. TRALI


Transfusion-Related Acute Lung Injury (TRALI) is a type of transfusion reaction characterized by lung damage after a blood transfusion. It occurs due because the transfused donor antibodies attack host neutrophils as well as host pulmonary endothelial cells. The resulting pulmonary edema and inflammation presents as shortness of breath and respiratory distress.

Key Points

  • Transfusion-Related Acute Lung Injury (TRALI)
    • Donor antibodies attack host neutrophils and pulmonary endothelial cells
      • Antibodies attack resting neutrophils in the lung, resulting in local inflammation and vascular leak
      • Contrast vs. FNHTR, where host antibodies attack donor neutrophils
    • Vascular leak and inflammation in lung causes pulmonary edema
      • Presents with shortness of breath and respiratory distress within 6 hours of transfusion
      • Other resting pools of host neutrophils attacked in liver and spleen, but effects may be subclinical (asymptomatic)