Babaev Arkady, Pozzi Federico, Hare Gregory, Zhang Haibo
Department of Anesthesia and Department of Physiology, University of Toronto, Canada.
J Anesth Crit Care. 2014 Jan 1;1(1). doi: 10.15406/jaccoa.2014.01.00002.
Transfusion-related acute lung injury (TRALI) is a major complication post-transfusion. A consensus definition of TRALI has been recently established to improve diagnosis but the pathogenesis of TRALI is yet to be understood. Although the antibody-mediated two-hit model of TRALI is the classical narrative, increasing evidence of the probable implications of prolonged storage of blood provides novel mechanisms towards storage lesion- the potentially injurious cellular and biochemical changes that occur in stored red blood cells. Red blood cell-derived lipids and micro vesicles may have been playing an important role in the development of TRALI. This article will provide a brief overview of the current understanding of TRALI and then discuss the implications and the potential mechanisms by which stored red blood cells may lead to TRALI.
输血相关急性肺损伤（TRALI）是输血后的一种主要并发症。最近已建立TRALI的共识定义以改善诊断，但TRALI的发病机制尚不清楚。尽管TRALI的抗体介导双打击模型是经典说法，但越来越多的证据表明血液长时间储存可能产生影响，这为储存损伤提供了新机制，储存损伤是指储存的红细胞中发生的潜在有害细胞和生化变化。红细胞衍生的脂质和微泡可能在TRALI的发生发展中起重要作用。本文将简要概述目前对TRALI的认识，然后讨论储存红细胞可能导致TRALI的影响及潜在机制。
