medigraphic.com
ISSN 2007-6509 (Print)
Órgano oficial de la Asociación Mexicana de Medicina Transfusional A.C.

2013, Number 1

<< Back Next >>

Rev Mex Med Transfus 2013; 6 (1)

Transfusion-Related Acute Lung Injury (TRALI) in cancer patient. Case report

Torres PJC, Martínez ÁJC, Arrazola GA, Suárez CA, Zavala MC, D’Artote GAL

Language: Spanish
References: 27
Page: 17-25
PDF size: 207.16 Kb.


ABSTRACT

Introduction: Transfusion related acute lung injury (TRALI) is an adverse reaction to blood transfusion. Reported risk in TRALI per blood component issued prior to 2004 in the UK was 1:556,000 per red cells in optimal additive solutions, German informs 1: 5000 with a mortality who reported fatality cause rate of 6 to 9%. In the USA, from 2004 to 2006 TRALI has been the first cause of death associated with blood transfusion. In Mexico, there is not statistical published information. Clinical case: GSM is a 38 years old female patient, with a diagnosis of colon cancer, who presented an adverse reaction to the transfusion in July 27, 2008 at 20:45 hours whith a concentrate to red cells concentrate transfusion (approximately 50 mL) group O Rh (o) D: positive, 30 minutes later she presented: cough, bronchial secretion, difficulty breath, tremors and shivers; the transfusion was suspended. Vital signs: (before and during) blood pressure: 110/70 mmHg, cardiac frequency: 80 per minute and temperature: 37.5 °C. The medical treatment to the patient was based on hydrocortisone sodium succinate 100 mg and diphenhydramine hydrochloride 25 mg both intravenosous and oxygen therapy, yielding partially the clinical course in 24 hours. Transfusion antecedents: 10 concentrates of red blood cells in the period that includes from 2000 to 2008. Laboratory. Results: blood biometry with 13.8 x 103 uL leukocytes, blood chemistry and hepatic tests (inside reference limits) urine with leukocyturia and bacteria. Serum albumin was 3.3 g/dL (value of reference 3.9 to 5.0 g/dL). Leukocyte antibodies positive and linfocitoxicity positive. Basal HLA class I positive %PRA 84 and basal HLA class II positive %PRA 74%. X-ray of thorax: normal. Conclusion: With the signs and clinical symptoms and the positive panel, there might establish a diagnosis of a possible TRALI (classification of cases according to Canadian Consensus Criteria) and for Council of Europe the severity scale: 2 and imputability scale: 3.


REFERENCES

  1. Rodríguez MH. TRALI: Daño pulmonar agudo por transfusión. Rev Med IMSS. 2004; 42 (6): 501-505.

  2. Goldman M, Webert KE, Arnold DM, Freedman J, Hannon J, Blajchman MA. Proceedings of a consensus conference: Towards an understanding of TRALI. Transf Med Rev. 2005; 19 (1): 2-31.

  3. Bux J. Leucocyte antibody-mediated transfusion reactions. ISBT Science Series. 2008; 3: 161-163.

  4. Sazama K. Transfusion 29, Abstract Suppl 42nd. New Orleans Lo: AABB Ann Meet; 1989: p. S121-S365.

  5. Fung L. The recipient side of TRALI the role of patient neutrophils. ISBT Science Series. 2007; 2: 135-140.

  6. Roupie E, Lepage E, Wysocki M et al. Prevalence etiologies and outcome of the acute respiratory distress syndrome hypoxemic ventilated patients. SRLF Collaborative Group on Mechanical Ventilation. Societe de Reanimation de Lague Francaise. Intensive Care Med. 1999; 25: 920-929.

  7. Flesch BK, Neppert J. Transfusion related acute lung injury caused by human leucocyte antigen class II antibody. Br J Haematol. 2002; 116: 673-676.

  8. Council of Europe. Haemovigilance. Chapter. 2004; 30: 231-232.

  9. Popovsky MA, Moore SB. Diagnostic and pathogenetic considerations in a transfusion-related acute lung injury. Transfusion. 1985; 25: 573-577.

  10. Win N, Ranacinghe E, Lucas G. Transfusion related acute lung injury: A 5 year look-back (letter). Transfusion Medicine. 2002; 12: 387-389.

  11. Kopko PM, Paglieroni TG, Popovsky MA et al. Transfusion related acute lung injury: Correlation on antigen-antibody and monocyte activation in donor-recipient pairs. Transfusion. 2003; 43: 177-184.

  12. Densmore TL, Goodnough LT, Ali S et al. Prevalence of HLA sensibilitization in female apheresis donors. Transfusion. 1999; 39: 103-106.

  13. Rodey G. HLA Beyond Tears. 2nd ed. USA: De Novo; 2000: p. 151.

  14. Goggind R, Geiselhart L. Antibody screening beyond tears. ASHI Quartely. 2003; 27 (2): 70-74.

  15. Silliman CC, Boshkov L, Mehdizadehkashi Z, Elzi DJ et al. Transfusion-related acute lung injury: Epidemiology and aprospective analysis of etiologic factors. Blood. 2003; 101: 454-462.

  16. Curtis BR, McFarland JG. Mechanisms of transfusion-related acute lung injury (TRALI): Anti-leukocyte antibodies. Crit Care Med. 2006; 34 (5 supl): S118-123.

  17. Silliman CC, Boshkov Lk, Mehdizadehkaski Z, Elzi DJ, Dickey WO, Podlosky L et al. Transfusion-related acute lung injury: Epidemiology and a prospective analysis of etiologic factors. Blood. 2003; 101 (2): 254-262.

  18. Noninfectious complications of blood transfusion. AABB Technical Manual. 17th ed. USA; 2011: pp. 746-747.

  19. Knowles S, Cohen H. On behalf of the Serious Hazards of Transfusion (SHOT) steering group. The 2010 Annual SHOT Report (2010). UK; 2010. Disponible en: www.shotuk.org

  20. Knowles S, Cohen H. On behalf of the Serious Hazards of Transfusion (SHOT) steering group. The 2011 Annual SHOT Report (2011). UK; 2011. Disponible en: www.shotuk.org

  21. Kopko PM, Popovsky MA, MacKenzie MR, Paglieroni TG, Muto KN, Holland PV. HLA class II antibodies in transfusion related acute lung injury. Transfusion. 2001; 41 (10): 1244-1248.

  22. Sachs UJ, Wasel W, Bayat B, Bohle RM, Hattar K, Berghöfer et al. Mechanism of transfusion related acute lung injury induced by HLA class II antibodies. Blood. 2011; 117 (2): 669-677.

  23. Curtis BR. Is TRALI caused by HLA class II too? Blood. 2011; 117 (2): 378-379.

  24. Contreras Marcela et al. ABC de la transfusión. “Complicaciones inmunológicas de la transfusión sanguínea” en daño agudo pulmonar relacionado a la transfusión (TRALI). 4a ed. México: Editorial Prado; 2009: pp. 93–94.

  25. Lucas G, Win N, Calvert A, Green A, Griffin E, Bendukidze N et al. Reducing the incidence of TRALI in UK: the results of screening for donor leucocyte antibodies and the development of national guidelines. Vox Sanguinis. 2012; 103 1: 10-17.

  26. Funk MB, Guenay S, Lohmann A, Henseler O, Hanschmann MO, Stanislawski KB. Benefit of transfusion related acute lung injury risk minimization measures German haemovigilance data (2006–2010). Vox Sanguinis. 2012; 102 (4): 317-323.

  27. Guidelines for the blood transfusion services in UK (red book) Section 16.8. Disponible en: http://transfusionguidelines.org.uk/index.aspx




2020     |     www.medigraphic.com