Moore S Breanndan
Division of Transfusion Medicine, Mayo Clinic and College of Medicine, 200 First Street SW, Rochester, MN 55905, USA.
Crit Care Med. 2006 May;34(5 Suppl):S114-7. doi: 10.1097/01.CCM.0000214312.20718.3E.
The term transfusion-related acute lung injury (TRALI) was coined in 1983 to describe a constellation of clinical and laboratory features seen within 6 hrs of the transfusion of plasma-containing blood products. These products contain antibodies directed to human leukocyte antigens (and subsequently described to nonhuman leukocyte antigens) found on white blood cells. In the intervening 2 decades, other cases not associated with antibodies have been reported as TRALI and an association with passive infusion of lipids accumulated in stored cellular blood products has been made in those cases. This has led to confusion as to what should be considered to constitute TRALI. Therefore, the true incidence of this pulmonary reaction to blood products is currently conjectural at best. Recent consensus development conferences have been held to develop and standardize definitions of TRALI so that epidemiologic and research aspects of this condition can be explored in a scientific manner. These conferences have set out criteria by which TRALI is distinguished from other causes of acute lung injury. This review outlines the widely accepted clinical (mainly pulmonary) features of TRALI, the treatment options, and the excellent long-term prognosis for patients who survive the initial pulmonary insult.
“输血相关急性肺损伤（TRALI）”这一术语于1983年被提出，用于描述在输注含血浆血液制品后6小时内出现的一系列临床和实验室特征。这些制品含有针对白细胞上人类白细胞抗原（随后也发现针对非人类白细胞抗原）的抗体。在随后的20年里，其他与抗体无关的病例也被报告为TRALI，并且在这些病例中发现与被动输注储存的细胞血液制品中积累的脂质有关。这导致了对于什么应被视为构成TRALI的困惑。因此，这种对血液制品的肺部反应的真实发生率目前充其量只是推测。最近召开了共识发展会议，以制定和规范TRALI的定义，从而能够以科学的方式探索这种病症的流行病学和研究方面。这些会议制定了将TRALI与其他急性肺损伤原因区分开来的标准。本综述概述了TRALI广泛认可的临床（主要是肺部）特征、治疗选择以及在初始肺部损伤中存活的患者良好的长期预后。
