Department of Intensive Care & Laboratory of Experimental Intensive Care & Anesthesiology, Academic Medical Center Amsterdam, The Netherlands.
Expert Rev Hematol. 2012 Feb;5(1):97-106. doi: 10.1586/ehm.11.74.
Transfusion-related acute lung injury (TRALI) is the leading cause of transfusion-related morbidity and mortality. Recent insights into the pathophysiology of TRALI have led to various preventive strategies. Strategies in donor management range from antibody testing of sensitized donors to the deferral of female plasma donors altogether. However, knowledge on the efficacy of measures to reduce TRALI is limited. In addition, the various measures may lead to a substantial loss of donors, hampering steady blood supply. Thereby, consensus among countries and blood-collecting facilities regarding the optimal strategy to prevent TRALI is lacking. In this review, the advantages and disadvantages of various preventive measures to prevent TRALI are discussed, related to both patient factors as well as blood component-processing strategies, including transfusion policy, donor management and practices of preparation and storage conditions of blood components.
输血相关性急性肺损伤（TRALI）是输血相关发病率和死亡率的主要原因。最近对 TRALI 病理生理学的深入了解导致了各种预防策略。供者管理策略包括对致敏供者进行抗体检测，甚至完全推迟女性血浆供者。然而，关于降低 TRALI 措施的效果的知识是有限的。此外，各种措施可能导致供者大量流失，从而影响稳定的血液供应。因此，各国和采血机构之间缺乏预防 TRALI 的最佳策略的共识。在这篇综述中，讨论了预防 TRALI 的各种预防措施的优缺点，这些措施涉及患者因素以及血液成分处理策略，包括输血政策、供者管理以及血液成分制备和储存条件的实践。
