Pearl Toy1, Peter Bacchetti2, Barbara Grimes2, Ognjen Gajic3, Edward L Murphy1,4, Jeffrey L Winters5, Michael A Gropper6, Rolf D Hubmayr3, Michael A Matthay7, Gregory Wilson8, Monique Koenigsberg1, Deanna C Lee1, Nora V Hirschler1,9, Clifford A Lowell1, Randy M Schuller10, Manish J Gandhi5, Philip J Norris1,4, David C Mair10, Rosa Sanchez Rosen1,4, Mark R Looney7,1. 1. Department of Laboratory Medicine, University of California at San Francisco, San Francisco, California. 2. Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, California. 3. Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota. 4. Blood Systems Research Institute, San Francisco, California. 5. Division of Transfusion Medicine, Mayo Clinic, Rochester, Minnesota. 6. Department of Anesthesia and Perioperative Care, University of California at San Francisco, San Francisco, California. 7. Department of Medicine, University of California at San Francisco, San Francisco, California. 8. Department of Anesthesia, Mayo Clinic, Rochester, Minnesota. 9. Blood Centers of the Pacific, San Francisco, California. 10. American Red Cross Neutrophil Reference Laboratory, North Central Blood Services, St Paul, Minnesota.
Abstract
BACKGROUND: Possible transfusion-related acute lung injury (pTRALI) cases by definition have a clear temporal relationship to an alternative recipient risk factor for acute respiratory distress syndrome (ARDS). We questioned whether transfusion factors are important for the development of pTRALI. STUDY DESIGN AND METHODS: In this nested case-control study, we prospectively identified 145 consecutive patients with pTRALI and randomly selected 163 transfused controls over a 4-year period at the University of California at San Francisco and the Mayo Clinic (Rochester, Minnesota). RESULTS: For pTRALI, we found evidence against transfusion being important: receipt of plasma from female donors (odds ratio [OR], 0.82; 95% confidence interval [CI], 0.29-2.3; p = 0.70), total number of units transfused (OR, 0.99; 95% CI, 0.89-1.10; p = 0.86), and number of red blood cell and whole blood units transfused (OR, 0.78; 95% CI, 0.59-1.03; p = 0.079). In contrast, we found that risk for pTRALI was associated with additional recipient factors: chronic alcohol abuse (OR, 12.5; 95% CI, 2.8-55; p < 0.001), current smoker (OR, 4.2; 95% CI, 1.67-10.8; p = 0.0024), shock before transfusion (OR, 4.6; 95% CI, 2.0-10.7; p < 0.001), and positive fluid balance before transfusion (OR, 1.32/L; 95% CI, 1.20-1.44; p < 0.001). CONCLUSION: Recipient risk factors for ARDS rather than transfusion risk factors predominate in pTRALI.
BACKGROUND: Possible transfusion-related acute lung injury (pTRALI) cases by definition have a clear temporal relationship to an alternative recipient risk factor for acute respiratory distress syndrome (ARDS). We questioned whether transfusion factors are important for the development of pTRALI. STUDY DESIGN AND METHODS: In this nested case-control study, we prospectively identified 145 consecutive patients with pTRALI and randomly selected 163 transfused controls over a 4-year period at the University of California at San Francisco and the Mayo Clinic (Rochester, Minnesota). RESULTS: For pTRALI, we found evidence against transfusion being important: receipt of plasma from female donors (odds ratio [OR], 0.82; 95% confidence interval [CI], 0.29-2.3; p = 0.70), total number of units transfused (OR, 0.99; 95% CI, 0.89-1.10; p = 0.86), and number of red blood cell and whole blood units transfused (OR, 0.78; 95% CI, 0.59-1.03; p = 0.079). In contrast, we found that risk for pTRALI was associated with additional recipient factors: chronic alcohol abuse (OR, 12.5; 95% CI, 2.8-55; p < 0.001), current smoker (OR, 4.2; 95% CI, 1.67-10.8; p = 0.0024), shock before transfusion (OR, 4.6; 95% CI, 2.0-10.7; p < 0.001), and positive fluid balance before transfusion (OR, 1.32/L; 95% CI, 1.20-1.44; p < 0.001). CONCLUSION: Recipient risk factors for ARDS rather than transfusion risk factors predominate in pTRALI.
Authors: Ognjen Gajic; Ousama Dabbagh; Pauline K Park; Adebola Adesanya; Steven Y Chang; Peter Hou; Harry Anderson; J Jason Hoth; Mark E Mikkelsen; Nina T Gentile; Michelle N Gong; Daniel Talmor; Ednan Bajwa; Timothy R Watkins; Emir Festic; Murat Yilmaz; Remzi Iscimen; David A Kaufman; Annette M Esper; Ruxana Sadikot; Ivor Douglas; Jonathan Sevransky; Michael Malinchoc Journal: Am J Respir Crit Care Med Date: 2010-08-27 Impact factor: 21.405
Authors: Steven Kleinman; Tim Caulfield; Penny Chan; Robertson Davenport; Janice McFarland; Susan McPhedran; Maureen Meade; Douglas Morrison; Thomas Pinsent; Pierre Robillard; Peter Slinger Journal: Transfusion Date: 2004-12 Impact factor: 3.157
Authors: Pearl Toy; Mark A Popovsky; Edward Abraham; Daniel R Ambruso; Leslie G Holness; Patricia M Kopko; Janice G McFarland; Avery B Nathens; Christopher C Silliman; David Stroncek Journal: Crit Care Med Date: 2005-04 Impact factor: 7.598
Authors: Arthur P Wheeler; Gordon R Bernard; B Taylor Thompson; David Schoenfeld; Herbert P Wiedemann; Ben deBoisblanc; Alfred F Connors; R Duncan Hite; Andrea L Harabin Journal: N Engl J Med Date: 2006-05-21 Impact factor: 91.245
Authors: Marc Moss; Polly E Parsons; Kenneth P Steinberg; Leonard D Hudson; David M Guidot; Ellen L Burnham; Stephanie Eaton; George A Cotsonis Journal: Crit Care Med Date: 2003-03 Impact factor: 7.598
Authors: Michelle Ng Gong; B Taylor Thompson; Paige Williams; Lucille Pothier; Paul D Boyce; David C Christiani Journal: Crit Care Med Date: 2005-06 Impact factor: 7.598
Authors: Gordon D Rubenfeld; Ellen Caldwell; Eve Peabody; Jim Weaver; Diane P Martin; Margaret Neff; Eric J Stern; Leonard D Hudson Journal: N Engl J Med Date: 2005-10-20 Impact factor: 91.245
Authors: Nareg H Roubinian; Jeanne E Hendrickson; Darrell J Triulzi; Jerome L Gottschall; Michael Michalkiewicz; Dhuly Chowdhury; Daryl J Kor; Mark R Looney; Michael A Matthay; Steven H Kleinman; Donald Brambilla; Edward L Murphy Journal: Crit Care Med Date: 2018-04 Impact factor: 7.598
Authors: Anna L Peters; Emma K Van De Weerdt; Eline J Goudswaard; Jan M Binnekade; Jaap J Zwaginga; Erik A M Beckers; Sacha S Zeerleder; Marian G J Van Kraaij; Nicole P Juffermans; Alexander P J Vlaar Journal: Blood Transfus Date: 2017-04-05 Impact factor: 3.443
Authors: N H Roubinian; J E Hendrickson; D J Triulzi; J L Gottschall; D Chowdhury; D J Kor; M R Looney; M A Matthay; S H Kleinman; D Brambilla; E L Murphy Journal: Vox Sang Date: 2016-12-21 Impact factor: 2.144
Authors: Martin D Zielinski; Gregory A Wilson; Pamela M Johnson; Stephanie F Polites; Donald H Jenkins; W Scott Harmsen; John B Holcomb; Charles E Wade; Deborah J Del Junco; Erin E Fox; James R Stubbs Journal: Surgery Date: 2016-07-20 Impact factor: 3.982
Authors: Pearl Toy; Mark R Looney; Mark Popovsky; Miodrag Palfi; Gösta Berlin; Catherine E Chapman; Paula Bolton-Maggs; Michael A Matthay Journal: Ann Am Thorac Soc Date: 2022-05
Authors: Alexander P J Vlaar; Pearl Toy; Mark Fung; Mark R Looney; Nicole P Juffermans; Juergen Bux; Paula Bolton-Maggs; Anna L Peters; Christopher C Silliman; Daryl J Kor; Steve Kleinman Journal: Transfusion Date: 2019-04-16 Impact factor: 3.157