Recipient clinical risk factors predominate in possible transfusion‐related acute lung injury. Issue 5 (8th December 2014)

• Record Type: Journal Article
• Authors: Toy, Pearl; Bacchetti, Peter; Grimes, Barbara; Gajic, Ognjen; Murphy, Edward L.; Winters, Jeffrey L.; Gropper, Michael A.; Hubmayr, Rolf D.; Matthay, Michael A.; Wilson, Gregory; Koenigsberg, Monique; Lee, Deanna C.; Hirschler, Nora V.; Lowell, Clifford A.; Schuller, Randy M.; Gandhi, Manish J.; Norris, Philip J.; Mair, David C.; Sanchez Rosen, Rosa; Looney, Mark R.
• Is Part Of: Transfusion. Volume 55:Issue 5(2015)
• Page Start: 947
• Page End: 952
• Publication Date: 2014-12-08
• Subjects: Hematology -- Periodicals; Blood -- Transfusion -- Periodicals; Blood Group Antigens -- Periodicals; Blood Preservation -- Periodicals; Blood Transfusion -- Periodicals; 615
• DOI: 10.1111/trf.12954
• Languages: English
• ISSNs: 0041-1132

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="trf12954-sec-0001" sec-type="section"> <title>Background</title> <p>Possible transfusion‐related acute lung injury (pTRALI) cases by definition have a clear temporal relationship to an alternative recipient risk factor for acute respiratory distress syndrome (ARDS). We questioned whether transfusion factors are important for the development of pTRALI.</p> </sec> <sec id="trf12954-sec-0002" sec-type="section"> <title>Study Design and Methods</title> <p>In this nested case‐control study, we prospectively identified 145 consecutive patients with pTRALI and randomly selected 163 transfused controls over a 4‐year period at the University of California at San Francisco and the Mayo Clinic (Rochester, Minnesota).</p> </sec> <sec id="trf12954-sec-0003" sec-type="section"> <title>Results</title> <p>For pTRALI, we found evidence against transfusion being important: receipt of plasma from female donors (odds ratio [OR], 0.82; 95% confidence interval [CI], 0.29‐2.3; p = 0.70), total number of units transfused (OR, 0.99; 95% CI, 0.89‐1.10; p = 0.86), and number of red blood cell and whole blood units transfused (OR, 0.78; 95% CI, 0.59‐1.03; p = 0.079). In contrast, we found that risk for pTRALI was associated with additional recipient factors: chronic alcohol abuse (OR, 12.5; 95% CI, 2.8‐55; p < 0.001), current smoker (OR, 4.2; 95% CI, 1.67‐10.8; p = 0.0024), shock before transfusion (OR, 4.6; 95% CI, 2.0‐10.7; p < 0.001), and positive fluid balance before transfusion (OR, 1.32/L; 95% CI, 1.20‐1.44; p < 0.001).</p> </sec> <sec id="trf12954-sec-0004" sec-type="section"> <title>Conclusion</title> <p>Recipient risk factors for ARDS rather than transfusion risk factors predominate in pTRALI.</p> </sec> </abstract>