Ten years of TRALI mitigation: measuring our progress
BACKGROUND Transfusion‐related acute lung injury (TRALI) is a leading cause of transfusion‐associated mortality for which multiple mitigation strategies have been implemented over the past decade. However, product‐specific TRALI rates have not been reported longitudinally and may help refine additio...
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| Veröffentlicht in: | Transfusion (Philadelphia, Pa.) Pa.), 2019-08, Vol.59 (8), p.2567-2574 |
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| creator | Vossoughi, Sarah Gorlin, Jed Kessler, Debra A. Hillyer, Christopher D. Van Buren, Nancy L. Jimenez, Alexandra Shaz, Beth H. |
| description | BACKGROUND
Transfusion‐related acute lung injury (TRALI) is a leading cause of transfusion‐associated mortality for which multiple mitigation strategies have been implemented over the past decade. However, product‐specific TRALI rates have not been reported longitudinally and may help refine additional mitigation strategies.
STUDY DESIGN AND METHODS
This retrospective multicenter study included analysis of TRALI rates from 2007 through 2017. Numerators included definite or probable TRALI reports from five blood centers serving nine states in the United States. Denominators were components distributed from participating centers. Rates were calculated as per 100,000 components distributed (p |
| doi_str_mv | 10.1111/trf.15387 |
| format | Article |
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Transfusion‐related acute lung injury (TRALI) is a leading cause of transfusion‐associated mortality for which multiple mitigation strategies have been implemented over the past decade. However, product‐specific TRALI rates have not been reported longitudinally and may help refine additional mitigation strategies.
STUDY DESIGN AND METHODS
This retrospective multicenter study included analysis of TRALI rates from 2007 through 2017. Numerators included definite or probable TRALI reports from five blood centers serving nine states in the United States. Denominators were components distributed from participating centers. Rates were calculated as per 100,000 components distributed (p < 0.05 significant).
RESULTS
One hundred four TRALI cases were reported from 10,012,707 components distributed (TRALI rate of 1.04 per 100,000 components). The TRALI rate was 2.25 for female versus 1.08 for male donated components (p < .001). The TRALI rate declined from 2.88 in 2007 to 0.60 in 2017. From 2007 to 2013, there was a significantly higher TRALI rate associated with female versus male plasma (33.85 vs. 1.59; p < 0.001) and RBCs (1.97 vs. 1.15; p = 0.03). From 2014 through 2017, after implementation of mitigation strategies, a significantly higher TRALI rate only from female‐donated plateletpheresis continued to be observed (2.98 vs. 0.75; p = 0.04).
CONCLUSION
Although the TRALI rates have substantially decreased secondary to multiple strategies over the past decade, a residual risk remains, particularly with female‐donated plateletpheresis products. Additional tools that may further mitigate TRALI incidence include the use of buffy coat pooled platelets suspended in male donor plasma or platelet additive solution due to the lower amounts of residual plasma.</description><identifier>ISSN: 0041-1132</identifier><identifier>EISSN: 1537-2995</identifier><identifier>DOI: 10.1111/trf.15387</identifier><identifier>PMID: 31145481</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley & Sons, Inc</publisher><subject>Blood Transfusion ; Buffy coat ; Databases, Factual ; Female ; Humans ; Incidence ; Lungs ; Male ; Platelets ; Retrospective Studies ; Risk Factors ; Transfusion ; Transfusion-Related Acute Lung Injury - blood ; Transfusion-Related Acute Lung Injury - epidemiology ; Transfusion-Related Acute Lung Injury - prevention & control ; United States - epidemiology</subject><ispartof>Transfusion (Philadelphia, Pa.), 2019-08, Vol.59 (8), p.2567-2574</ispartof><rights>2019 AABB</rights><rights>2019 AABB.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3537-2dad9feb06c6de597da6c7fdca8237629b00cf6d7bff23df84c26938fe5745513</citedby><cites>FETCH-LOGICAL-c3537-2dad9feb06c6de597da6c7fdca8237629b00cf6d7bff23df84c26938fe5745513</cites><orcidid>0000-0001-8161-4888</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Ftrf.15387$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Ftrf.15387$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31145481$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Vossoughi, Sarah</creatorcontrib><creatorcontrib>Gorlin, Jed</creatorcontrib><creatorcontrib>Kessler, Debra A.</creatorcontrib><creatorcontrib>Hillyer, Christopher D.</creatorcontrib><creatorcontrib>Van Buren, Nancy L.</creatorcontrib><creatorcontrib>Jimenez, Alexandra</creatorcontrib><creatorcontrib>Shaz, Beth H.</creatorcontrib><title>Ten years of TRALI mitigation: measuring our progress</title><title>Transfusion (Philadelphia, Pa.)</title><addtitle>Transfusion</addtitle><description>BACKGROUND
Transfusion‐related acute lung injury (TRALI) is a leading cause of transfusion‐associated mortality for which multiple mitigation strategies have been implemented over the past decade. However, product‐specific TRALI rates have not been reported longitudinally and may help refine additional mitigation strategies.
STUDY DESIGN AND METHODS
This retrospective multicenter study included analysis of TRALI rates from 2007 through 2017. Numerators included definite or probable TRALI reports from five blood centers serving nine states in the United States. Denominators were components distributed from participating centers. Rates were calculated as per 100,000 components distributed (p < 0.05 significant).
RESULTS
One hundred four TRALI cases were reported from 10,012,707 components distributed (TRALI rate of 1.04 per 100,000 components). The TRALI rate was 2.25 for female versus 1.08 for male donated components (p < .001). The TRALI rate declined from 2.88 in 2007 to 0.60 in 2017. From 2007 to 2013, there was a significantly higher TRALI rate associated with female versus male plasma (33.85 vs. 1.59; p < 0.001) and RBCs (1.97 vs. 1.15; p = 0.03). From 2014 through 2017, after implementation of mitigation strategies, a significantly higher TRALI rate only from female‐donated plateletpheresis continued to be observed (2.98 vs. 0.75; p = 0.04).
CONCLUSION
Although the TRALI rates have substantially decreased secondary to multiple strategies over the past decade, a residual risk remains, particularly with female‐donated plateletpheresis products. Additional tools that may further mitigate TRALI incidence include the use of buffy coat pooled platelets suspended in male donor plasma or platelet additive solution due to the lower amounts of residual plasma.</description><subject>Blood Transfusion</subject><subject>Buffy coat</subject><subject>Databases, Factual</subject><subject>Female</subject><subject>Humans</subject><subject>Incidence</subject><subject>Lungs</subject><subject>Male</subject><subject>Platelets</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Transfusion</subject><subject>Transfusion-Related Acute Lung Injury - blood</subject><subject>Transfusion-Related Acute Lung Injury - epidemiology</subject><subject>Transfusion-Related Acute Lung Injury - prevention & control</subject><subject>United States - epidemiology</subject><issn>0041-1132</issn><issn>1537-2995</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp10E1LwzAcBvAgipvTg19ACl700C0vTdJ6G8PpYCCMeg5pXkZHX2bSIvv2xnV6EMzlf_nx5OEB4BbBKQpv1jk7RZSk_AyMw-UxzjJ6DsYQJihGiOARuPJ-ByHEGUSXYEQQSmiSojGguWmig5HOR62N8s18vYrqsiu3sivb5imqjfS9K5tt1PYu2rt264z31-DCysqbm9OdgPflc754jddvL6vFfB0rcqyhpc6sKSBTTBuacS2Z4lYrmWLCGc4KCJVlmhfWYqJtmijMMpJaQ3lCKSIT8DDkho8_euM7UZdemaqSjWl7LzAmOOHB8kDv_9BdaNyEdkExntKMsTSox0Ep13rvjBV7V9bSHQSC4ntLEbYUxy2DvTsl9kVt9K_8GS-A2QA-y8oc_k8S-WY5RH4BcvJ8Ew</recordid><startdate>201908</startdate><enddate>201908</enddate><creator>Vossoughi, Sarah</creator><creator>Gorlin, Jed</creator><creator>Kessler, Debra A.</creator><creator>Hillyer, Christopher D.</creator><creator>Van Buren, Nancy L.</creator><creator>Jimenez, Alexandra</creator><creator>Shaz, Beth H.</creator><general>John Wiley & Sons, Inc</general><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>7U9</scope><scope>8FD</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-8161-4888</orcidid></search><sort><creationdate>201908</creationdate><title>Ten years of TRALI mitigation: measuring our progress</title><author>Vossoughi, Sarah ; Gorlin, Jed ; Kessler, Debra A. ; Hillyer, Christopher D. ; Van Buren, Nancy L. ; Jimenez, Alexandra ; Shaz, Beth H.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3537-2dad9feb06c6de597da6c7fdca8237629b00cf6d7bff23df84c26938fe5745513</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Blood Transfusion</topic><topic>Buffy coat</topic><topic>Databases, Factual</topic><topic>Female</topic><topic>Humans</topic><topic>Incidence</topic><topic>Lungs</topic><topic>Male</topic><topic>Platelets</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Transfusion</topic><topic>Transfusion-Related Acute Lung Injury - blood</topic><topic>Transfusion-Related Acute Lung Injury - epidemiology</topic><topic>Transfusion-Related Acute Lung Injury - prevention & control</topic><topic>United States - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Vossoughi, Sarah</creatorcontrib><creatorcontrib>Gorlin, Jed</creatorcontrib><creatorcontrib>Kessler, Debra A.</creatorcontrib><creatorcontrib>Hillyer, Christopher D.</creatorcontrib><creatorcontrib>Van Buren, Nancy L.</creatorcontrib><creatorcontrib>Jimenez, Alexandra</creatorcontrib><creatorcontrib>Shaz, Beth H.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Transfusion (Philadelphia, Pa.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Vossoughi, Sarah</au><au>Gorlin, Jed</au><au>Kessler, Debra A.</au><au>Hillyer, Christopher D.</au><au>Van Buren, Nancy L.</au><au>Jimenez, Alexandra</au><au>Shaz, Beth H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Ten years of TRALI mitigation: measuring our progress</atitle><jtitle>Transfusion (Philadelphia, Pa.)</jtitle><addtitle>Transfusion</addtitle><date>2019-08</date><risdate>2019</risdate><volume>59</volume><issue>8</issue><spage>2567</spage><epage>2574</epage><pages>2567-2574</pages><issn>0041-1132</issn><eissn>1537-2995</eissn><abstract>BACKGROUND
Transfusion‐related acute lung injury (TRALI) is a leading cause of transfusion‐associated mortality for which multiple mitigation strategies have been implemented over the past decade. However, product‐specific TRALI rates have not been reported longitudinally and may help refine additional mitigation strategies.
STUDY DESIGN AND METHODS
This retrospective multicenter study included analysis of TRALI rates from 2007 through 2017. Numerators included definite or probable TRALI reports from five blood centers serving nine states in the United States. Denominators were components distributed from participating centers. Rates were calculated as per 100,000 components distributed (p < 0.05 significant).
RESULTS
One hundred four TRALI cases were reported from 10,012,707 components distributed (TRALI rate of 1.04 per 100,000 components). The TRALI rate was 2.25 for female versus 1.08 for male donated components (p < .001). The TRALI rate declined from 2.88 in 2007 to 0.60 in 2017. From 2007 to 2013, there was a significantly higher TRALI rate associated with female versus male plasma (33.85 vs. 1.59; p < 0.001) and RBCs (1.97 vs. 1.15; p = 0.03). From 2014 through 2017, after implementation of mitigation strategies, a significantly higher TRALI rate only from female‐donated plateletpheresis continued to be observed (2.98 vs. 0.75; p = 0.04).
CONCLUSION
Although the TRALI rates have substantially decreased secondary to multiple strategies over the past decade, a residual risk remains, particularly with female‐donated plateletpheresis products. Additional tools that may further mitigate TRALI incidence include the use of buffy coat pooled platelets suspended in male donor plasma or platelet additive solution due to the lower amounts of residual plasma.</abstract><cop>Hoboken, USA</cop><pub>John Wiley & Sons, Inc</pub><pmid>31145481</pmid><doi>10.1111/trf.15387</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0001-8161-4888</orcidid></addata></record> |
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| subjects | Blood Transfusion Buffy coat Databases, Factual Female Humans Incidence Lungs Male Platelets Retrospective Studies Risk Factors Transfusion Transfusion-Related Acute Lung Injury - blood Transfusion-Related Acute Lung Injury - epidemiology Transfusion-Related Acute Lung Injury - prevention & control United States - epidemiology |
| title | Ten years of TRALI mitigation: measuring our progress |
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