Transfusion-related acute lung injury: a clinical review

Lancet. 2013 Sep 14;382(9896):984-94. doi: 10.1016/S0140-6736(12)62197-7. Epub 2013 May 1.


Three decades ago, transfusion-related acute lung injury (TRALI) was considered a rare complication of transfusion medicine. Nowadays, the US Food and Drug Administration acknowledge the syndrome as the leading cause of transfusion-related mortality. Understanding of the pathogenesis of TRALI has resulted in the design of preventive strategies from a blood-bank perspective. A major breakthrough in efforts to reduce the incidence of TRALI has been to exclude female donors of products with high plasma volume, resulting in a decrease of roughly two-thirds in incidence. However, this strategy has not completely eradicated the complication. In the past few years, research has identified patient-related risk factors for the onset of TRALI, which have empowered physicians to take an individualised approach to patients who need transfusion.

Publication types

  • Review

MeSH terms

  • Acute Lung Injury / diagnosis
  • Acute Lung Injury / etiology*
  • Antibody Formation / physiology
  • Cytokines / metabolism
  • Humans
  • Neutrophil Activation / immunology
  • Neutrophil Activation / physiology
  • Neutrophils / immunology
  • Pulmonary Edema / etiology
  • Time Factors
  • Transfusion Reaction*


  • Cytokines