Blood Systems Research Institute, San Francisco, CA; Kaiser Permanente Northern California Medical Center and Division of Research, Oakland, CA; and Department of Laboratory Medicine, University of California, San Francisco, CA.
Hematology Am Soc Hematol Educ Program. 2018 Nov 30;2018(1):585-594. doi: 10.1182/asheducation-2018.1.585. Epub 2018 Dec 14.
Transfusion-related acute lung injury (TRALI) and transfusion-associated circulatory overload (TACO) are the leading causes of transfusion-related morbidity and mortality. These adverse events are characterized by acute pulmonary edema within 6 hours of a blood transfusion and have historically been difficult to study due to underrecognition and nonspecific diagnostic criteria. However, in the past decade, in vivo models and clinical studies utilizing active surveillance have advanced our understanding of their epidemiology and pathogenesis. With the adoption of mitigation strategies and patient blood management, the incidence of TRALI and TACO has decreased. Continued research to prevent and treat these severe cardiopulmonary events is focused on both the blood component and the transfusion recipient.
输血相关急性肺损伤（TRALI）和输血相关循环超负荷（TACO）是输血相关发病率和死亡率的主要原因。这些不良事件的特征是输血后 6 小时内发生急性肺水肿，由于认识不足和诊断标准不明确，历史上很难对其进行研究。然而，在过去十年中，利用主动监测的体内模型和临床研究提高了我们对其流行病学和发病机制的认识。通过采取缓解策略和患者血液管理，TRALI 和 TACO 的发生率有所下降。继续研究预防和治疗这些严重心肺事件的重点是血液成分和输血受者。
