Standardized reporting of pulmonary transfusion complications: Development of a model reporting form and flowchart

Stefan F. van Wonderen, Anna L. Peters, Sharran Grey, Srijana Rajbhandary, Layla L. de Jonge, Chester Andrzejewski, Shruthi Narayan, Johanna C. Wiersum-Osselton, Alexander P. J. Vlaar

Research output: Contribution to journalArticleAcademicpeer-review

1 Citation (Scopus)


Background: Pulmonary complications of blood transfusion, including transfusion-related acute lung injury (TRALI), transfusion-associated circulatory overload (TACO), and transfusion-associated dyspnea, are generally underdiagnosed and under-reported. The international TRALI and TACO definitions have recently been updated. Currently, no standardized pulmonary transfusion reaction reporting form exists and most of the hemovigilance forms have not yet incorporated the updated definitions. We developed a harmonized reporting form, aimed at improved data collection on pulmonary transfusion reactions for hemovigilance and research purposes by developing a standardized model reporting form and flowchart. Materials and Methods: Using a modified Delphi method among an international, multidisciplinary panel of 24 hemovigilance experts, detailed recommendations were developed for a standardized model reporting form for pulmonary complications of blood transfusion. Two Delphi rounds, including scoring systems, took place and several subsequent meetings were held to discuss issues and obtain consensus. Additionally, a flowchart was developed incorporating recently published redefinitions of pulmonary transfusion reactions. Results: In total, 17 participants completed the first questionnaire (70.8% response rate) and 14 participants completed the second questionnaire (58.3% response rate). According to the results from the questionnaires, the standardized model reporting form was divided into various subcategories: general information, patient history and transfusion characteristics, reaction details, investigations, treatment and supportive care, narrative, and transfused product. Conclusion: In this article, we present the recommendations from a global group of experts in the hemovigilance field. The standardized model reporting form and flowchart provide an initiative that may improve data collected to address pulmonary transfusion reactions.
Original languageEnglish
Pages (from-to)1161-1171
Number of pages11
Issue number6
Early online date2023
Publication statusPublished - Jun 2023


  • anaphylaxis
  • flowchart
  • hemovigilance
  • reporting
  • transfusion-associated circulatory overload
  • transfusion-associated dyspnea
  • transfusion-related acute lung injury

Cite this