Transfusion-related Acute Lung Injury (TRALI): Warning Signs and How to Avoid It.

Transfusion-related acute lung injury (TRALI) is a form of acute lung injury caused by blood transfusion. Diagnostic criteria have been revised over the years to align with ARDS criteria. The pathophysiology involves either passive transfer of leukocyte antibodies or accumulation of inflammatory mediators in stored blood products. Risk factors include critical illness, surgery, and transfusion of plasma containing HLA or HNA antibodies. Mitigation strategies such as male donors and leukoreduction have reduced but not eliminated TRALI. It remains an important cause of transfusion-related mortality. Further research on risk factors, biomarkers and treatments is needed to improve diagnosis, prevention and management of this serious complication of transfusion. Supportive care is the current mainstay of treatment for TRALI.