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Transfusion-Related Acute Lung Injury
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To the Editor: In their look-back investigation,
Dr Kopko and colleagues1 reported that 36%
of patients who received transfusions from a frequent plasma donor had reactions
consistent with transfusion-related acute lung injury (TRALI). They also found
that the donor had an anti-5b, a granulocyte-specific alloantibody, which
has been associated with TRALI in both humans and in animal models.2-3
I performed a similar clinical look-back investigation of a frequent
apheresis platelet and plasma donor. The donor was a gravida 3, para 3 woman,
who had donated a total of 16 apheresis platelet concentrates and 4 units
of fresh frozen plasma over a 3-year period. Of 20 recipients, a transfusion
reaction was identified in 3 patients. All 3 had evidence of respiratory involvement,
manifested by coughing, wheezing, labored breathing, tachypnea, and oxygen
desaturation. Two patients also had radiographic evidence of bilateral pulmonary
infiltrates. One patient required a short course of mechanical ventilation.
. . . [Full Text of this Article]
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