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What is TRALI?

Updated: 8/20/2019
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transfusion related acute lung injury

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Q: What is TRALI?
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What is the possible cause of death in a blood transfusion?

These complications may include an acute hemolytic transfusion reaction (AHTR), which is most commonly caused by ABO incompatibility. The patient may complain of pain, difficult breathing, fever and chills, facial flushing, and nausea.


What are the risks of blood transfusion?

If everyone involved in the process has done their job, there are no risks in having a blood transfusion. However, humans being prone to error, there are some risks such as * Mistyping (not getting the bloodtype of the donor and/or the patient right); * Contamination (the blood not being stored correctly or having drugs or diseases which were not noticed - this is extreme rare); * Volume and iron overload (too much blood being transfused and too many red platelets being given); * Allergic reactions; * Some serious conditions such as TRALI, most of which occur exceedingly rarely. * There are also some reaction symptoms which occur in many cases anyway, and resolve themselves fairly quickly.


What happens when they do not match for blood groups?

Although blood transfusions can be life-saving, they are not without risks. Blood transfusions sometimes cause transfusion reactions. There are several types of reactions and some are worse than others. Some reactions happen as soon as the transfusion is started, while others take several days or even longer to develop. 1-Allergic reaction Usually the only symptoms are hives and itching, which can be treated with antihistamines like diphenhydramine (Benadryl). 2-Febrile reaction This means that that the person gets a sudden fever during or within 24 hours of the transfusion. Headache, nausea, chills, or a general feeling of discomfort may come with the fever. Acetaminophen (Tylenol) may help these symptoms. 3- Transfusion-related acute lung injury It often starts within 1 to 2 hours of starting the transfusion, but can happen anytime up to 6 hours after a transfusion. The main symptom of TRALI is trouble breathing. 4- Acute immune hemolytic reaction It happens when donor and patient blood types do not match. The patient's antibodies attack the transfused red blood cells, causing them to break open (hemolyze) and release harmful substances into the bloodstream. Patients may have chills, fever, chest and lower back pain, and nausea. The kidneys may be badly damaged, and dialysis may be needed. A hemolytic reaction can be deadly if the transfusion is not stopped as soon as the reaction starts. 5-Delayed hemolytic reaction This type of reaction happens when the body slowly attacks antigens (other than ABO antigens) on the transfused blood cells. The blood cells are broken down days or weeks after the transfusion. There are usually no symptoms, but the transfused red blood cells are destroyed and the patient's red blood cell count falls. In rare cases the kidneys may be affected, and treatment may be needed. 6-Graft-versus-host disease Graft-versus-host disease (GVHD) occurs when a person with a very weak immune system gets white blood cells in a transfused blood product. The white cells from the transfusion attack the tissues of the patient who got the blood. Hope these help =)