TY - JOUR T1 - Transfusion-related acute lung injury: incidence and risk factors. JF - Blood//Blood Y1 - 2012 A1 - Toy, Pearl A1 - Gajic, Ognjen A1 - Bacchetti, Peter A1 - Looney, Mark R A1 - Gropper, Michael A A1 - Hubmayr, Rolf A1 - Lowell, Clifford A A1 - Norris, Philip J A1 - Murphy, Edward L A1 - Weiskopf, Richard B A1 - Wilson, Gregory A1 - Koenigsberg, Monique A1 - Lee, Deanna A1 - Schuller, Randy A1 - Wu, Ping A1 - Grimes, Barbara A1 - Gandhi, Manish J A1 - Winters, Jeffrey L A1 - Mair, David A1 - Hirschler, Nora A1 - Sanchez Rosen, Rosa A1 - Matthay, Michael A A1 - TRALI Study Group KW - *Acute Lung Injury/ep [Epidemiology] KW - *Acute Lung Injury/et [Etiology] KW - *Blood Transfusion/ae [Adverse Effects] KW - Academic Medical Centers/sn [Statistics & Numerical Data] KW - Adult KW - Aged KW - Blood Transfusion/sn [Statistics & Numerical Data] KW - Case-Control Studies KW - Female KW - Humans KW - Incidence KW - Male KW - Middle Aged KW - Population Surveillance KW - Retrospective Studies KW - Risk Factors KW - Young Adult AB - Transfusion-related acute lung injury (TRALI) is the leading cause of transfusion-related mortality. To determine TRALI incidence by prospective, active surveillance and to identify risk factors by a case-control study, 2 academic medical centers enrolled 89 cases and 164 transfused controls. Recipient risk factors identified by multivariate analysis were higher IL-8 levels, liver surgery, chronic alcohol abuse, shock, higher peak airway pressure while being mechanically ventilated, current smoking, and positive fluid balance. Transfusion risk factors were receipt of plasma or whole blood from female donors (odds ratio = 4.5, 95% confidence interval [CI], 1.85-11.2, P = .001), volume of HLA class II antibody with normalized background ratio more than 27.5 (OR = 1.92/100 mL, 95% CI, 1.08-3.4, P = .03), and volume of anti-human neutrophil antigen positive by granulocyte immunofluoresence test (OR = 1.71/100 mL, 95% CI, 1.18-2.5, P = .004). Little or no risk was associated with older red blood cell units, noncognate or weak cognate class II antibody, or class I antibody. Reduced transfusion of plasma from female donors was concurrent with reduced TRALI incidence: 2.57 (95% CI, 1.72-3.86) in 2006 versus 0.81 (95% CI, 0.44-1.49) in 2009 per 10 000 transfused units (P = .002). The identified risk factors provide potential targets for reducing residual TRALI. M1 - a8g, 7603509 PB - Toy,Pearl. Department of Laboratory Medicine, Box 0451, University of California-San Francisco, San Francisco, CA 94143-0451, USA. pearl.toy@ucsf.edu CY - United States VL - 119 SN - 1528-0020 CP - 7 N1 - Comment in: Blood. 2012 Feb 16;119(7):1620-1; PMID: 22343662 L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=medl&NEWS=N&AN=22117051 ID - 4338 ER -