输血相关急性肺损伤（TRALI）：当前的概念与误解
Transfusion-related acute lung injury (TRALI): current concepts and misconceptions.
作者信息
Silliman Christopher C, Fung Yoke Lin, Ball J Bradley, Khan Samina Y
机构信息
Research Department, Bonfils Blood Center, Denver CO 80230, USA.
出版信息
Blood Rev. 2009 Nov;23(6):245-55. doi: 10.1016/j.blre.2009.07.005. Epub 2009 Aug 20.
Abstract
Transfusion-related acute lung injury (TRALI) is the most common cause of serious morbidity and mortality due to hemotherapy. Although the pathogenesis has been related to the infusion of donor antibodies into the recipient, antibody negative TRALI has been reported. Changes in transfusion practices, especially the use of male-only plasma, have decreased the number of antibody-mediated cases and deaths; however, TRALI still occurs. The neutrophil appears to be the effector cell in TRALI and the pathophysiology is centered on neutrophil-mediated endothelial cell cytotoxicity resulting in capillary leak and ALI. This review will detail the pathophysiology of TRALI including recent pre-clinical data, provide insight into newer areas of research, and critically assess current practices to decrease it prevalence and to make transfusion safer.
摘要
输血相关急性肺损伤（TRALI）是血液治疗导致严重发病和死亡的最常见原因。尽管其发病机制与供体抗体输注到受者体内有关，但也有抗体阴性的TRALI报道。输血实践的改变，尤其是仅使用男性血浆，已减少了抗体介导的病例数和死亡人数；然而，TRALI仍然会发生。中性粒细胞似乎是TRALI中的效应细胞，其病理生理学集中在中性粒细胞介导的内皮细胞细胞毒性，导致毛细血管渗漏和急性肺损伤。本综述将详细阐述TRALI的病理生理学，包括近期临床前数据，深入探讨新的研究领域，并批判性地评估当前的做法，以降低其发生率并使输血更安全。
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