Transfusion-Related Acute Lung Injury After Transfusion of Maternal Blood
| Autor: | Mohammad Diab, Pearl Toy, Margaret E. Cooke, Nancy M. Dunbar |
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| Rok vydání: | 2010 |
| Předmět: |
Male
medicine.medical_specialty Blood transfusion Adolescent medicine.medical_treatment Acute Lung Injury Population Blood Donors Lung injury Article Risk Factors Blood product Humans Medicine Orthopedics and Sports Medicine Child education Intensive care medicine Retrospective Studies education.field_of_study Pregnancy business.industry Medical record Transfusion Reaction Retrospective cohort study medicine.disease Case-Control Studies Emergency medicine Female Neurology (clinical) business Transfusion-related acute lung injury |
| Zdroj: | Spine. 35:E1322-E1327 |
| ISSN: | 0362-2436 |
| Popis: | Study design This is a single-center retrospective case-control study of 7 transfusion-related acute lung injury (TRALI) cases and 28 controls in the pediatric spinal surgery population. Objective To determine the association between maternal transfusion and risk of TRALI in pediatric spinal surgery patients. Summary of background data Previous studies support a "2-hit" model for the pathogenesis of TRALI-activation and sequestration of neutrophils in the pulmonary vasculature followed by transfusion of a biologic response modifier such as antileukocyte antibodies. Maternal donation of blood products is a potential risk factor for TRALI because of the development of antileukocyte antibodies during pregnancy. Until now there have been no studies specifically addressing the risk of TRALI following maternal transfusions. Methods This is a retrospective case-control study of 7 TRALI cases with 4 controls per case, matched by strata for volume of plasma transfused. All cases identified by the Transfusion Biology and Medicine Specialized Center of Clinically Oriented Research with a TRALI diagnosis were eligible for inclusion. Electronic medical records and operative notes were reviewed to obtain demographic data, diagnosis, surgical approach, and number of spine levels for each operation. Results An increased prevalence of maternal blood transfusion was found among the TRALI cases compared with the control cases: 43% (3 of 7) versus 7% (2 of 28), P = 0.044. There were otherwise no statistical differences between the groups, including age, gender, surgical approach, number of spinal levels, or type of blood product transfused. Conclusion Pediatric patients undergoing spinal surgery may be at increased risk for the development of TRALI following the transfusion of maternal blood products. Accordingly, we recommend that directed donation of maternal blood products should be avoided in this population. This study also found that TRALI may be underrecognized and underreported to the transfusion service. |
| Databáze: | OpenAIRE |
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