TY - JOUR
T1 - Reported transfusion-related acute lung injury associated with solvent/detergent plasma – A case series
AU - Klanderman, Robert B.
AU - Bulle, Esther B.
AU - Heijnen, Josephine W. M.
AU - Allen, Judith
AU - Purmer, Ilse M.
AU - Kerkhoffs, Jean-Louis H.
AU - Wiersum-Osselton, Johanna C.
AU - Vlaar, Alexander P. J.
N1 - Funding Information: The authors would like to thank dr. Jennita Slomp from Medisch Spectrum Twente, dr. Gijs den Beste from Isala Hospital, dr. Mathie Leers from Zuyderland Medisch Centrum and prof. dr. Jaap Jan Zwaginga of Leiden University Medical Center for contributing by reporting cases and collecting anonymized patient data. Funding Information: The research was funded by a personal grant from the Dutch Research Council (NWO) awarded to Prof. Dr. A.P.J. Vlaar ‐ VIDI grant (number: 09150172010047) as well as support from departmental resources from the Department of Intensive Care Medicine at Amsterdam UMC – location AMC. Funding information Publisher Copyright: © 2022 The Authors. Transfusion published by Wiley Periodicals LLC on behalf of AABB.
PY - 2022/3
Y1 - 2022/3
N2 - Background: Antibody-mediated transfusion-related acute lung injury (TRALI) is caused by donor HLA or HNA antibodies in plasma-containing products. In the Netherlands 55,000 units of solvent/detergent plasma (SDP), a pooled plasma product, are transfused yearly. It's produced by combining plasma from hundreds of donors, diluting harmful antibodies. Due to a lack of reported cases following implementation, some have labeled SDP as “TRALI safe”. Study design and methods: Pulmonary transfusion reactions involving SDP reported to the Dutch national hemovigilance network in 2016–2019 were reviewed. Reporting hospitals were contacted for additional information, cases with TRALI and imputability definite, probable, or possible were included and informed consent was sought. Results: A total of three TRALI and nine TACO cases were reported involving SDP. The imputability of one TRALI case was revised from possible to unlikely and excluded; in one case no informed consent was obtained. We present a case description of TRALI following SDP transfusion in a 69-year-old male, 3 days following endovascular aortic aneurysm repair. The patient received one unit of SDP to correct a heparin-induced coagulopathy, prior to removal of a spinal catheter post-operatively. Within five hours he developed hypoxemic respiratory failure requiring intubation, hypotension, bilateral chest infiltrates, and leucopenia. The patient made a full recovery. Conclusion: This case of TRALI, following transfusion of a single unit of SDP to a patient without ARDS risk factors, demonstrates that TRALI can occur with this product. Clinicians should remain vigilant and continue to report suspected cases, to help further understanding of SDP-associated TRALI.
AB - Background: Antibody-mediated transfusion-related acute lung injury (TRALI) is caused by donor HLA or HNA antibodies in plasma-containing products. In the Netherlands 55,000 units of solvent/detergent plasma (SDP), a pooled plasma product, are transfused yearly. It's produced by combining plasma from hundreds of donors, diluting harmful antibodies. Due to a lack of reported cases following implementation, some have labeled SDP as “TRALI safe”. Study design and methods: Pulmonary transfusion reactions involving SDP reported to the Dutch national hemovigilance network in 2016–2019 were reviewed. Reporting hospitals were contacted for additional information, cases with TRALI and imputability definite, probable, or possible were included and informed consent was sought. Results: A total of three TRALI and nine TACO cases were reported involving SDP. The imputability of one TRALI case was revised from possible to unlikely and excluded; in one case no informed consent was obtained. We present a case description of TRALI following SDP transfusion in a 69-year-old male, 3 days following endovascular aortic aneurysm repair. The patient received one unit of SDP to correct a heparin-induced coagulopathy, prior to removal of a spinal catheter post-operatively. Within five hours he developed hypoxemic respiratory failure requiring intubation, hypotension, bilateral chest infiltrates, and leucopenia. The patient made a full recovery. Conclusion: This case of TRALI, following transfusion of a single unit of SDP to a patient without ARDS risk factors, demonstrates that TRALI can occur with this product. Clinicians should remain vigilant and continue to report suspected cases, to help further understanding of SDP-associated TRALI.
KW - SDP
KW - TRALI
KW - plasma
KW - solvent/detergent
UR - http://www.scopus.com/inward/record.url?scp=85124741554&partnerID=8YFLogxK
U2 - https://doi.org/10.1111/trf.16822
DO - https://doi.org/10.1111/trf.16822
M3 - Article
C2 - 35174882
SN - 0041-1132
VL - 62
SP - 594
EP - 599
JO - Transfusion
JF - Transfusion
IS - 3
ER -