The two-event model of transfusion-related acute lung injury

Crit Care Med. 2006 May;34(5 Suppl):S124-31. doi: 10.1097/01.CCM.0000214292.62276.8E.


The objective of this review is to present the two-event model of transfusion-related acute lung injury (TRALI), a life-threatening complication of transfusions that has been the most common cause of transfusion-related death over the past 2 yrs in the United States. The two-event model of TRALI, which is identical to the pathogenesis of the acute respiratory distress syndrome (ARDS), is reviewed and contrasted to antibody-mediated TRALI. Laboratory studies, both in vitro and in vivo, are discussed as well as human studies of TRALI. Methods to avoid patient exposure to blood components that may cause TRALI are also discussed.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Antigen-Antibody Reactions
  • Clinical Trials as Topic
  • Endothelium / immunology
  • Histocompatibility Antigens Class I / immunology
  • Histocompatibility Antigens Class II / immunology
  • Humans
  • Isoantibodies / immunology
  • Lung / immunology
  • Models, Biological
  • Neutrophils / immunology
  • Respiratory Distress Syndrome / etiology*
  • Respiratory Distress Syndrome / immunology*
  • Transfusion Reaction*


  • Histocompatibility Antigens Class I
  • Histocompatibility Antigens Class II
  • Isoantibodies