ANALYSIS OF CASES SHOWING RESPIRATORY FAILURE AS A TRANSFUSION SIDE EFFECT

Abstract

In national university hospitals, nationwide records have been maintained of the transfusion side effects occurring each year. After the recommended criteria for transfusion-related acute lung injury (TRALI) were established during the TRALI Consensus Conference held in 2004, cases of respiratory failure were re-examined.
Thirty-four cases of respiratory failure were reported by 44 facilities during the fiscal year 1998 to 2003. Eight cases were diagnosed as TRALI and three cases as possible TRALI according to the recommended criteria. The antileukocyte antibody was positive in 63% (7/11) of cases that met the recommended criteria, although the anti-HLAclass II antibody was tested in only three cases. One case showed signs of acute lung injury (ALI) before transfusion, and 22 cases that did not show bilateral infiltrate on the chest radiograph were excluded. Twenty-two cases with no bilateral infiltrate on the chest radiograph seemed to be the result of an allergic reaction or condition similar to TRALI.
Seven deaths occurred in cases involving TRALI, which was the most important serious complication related to transfusion during the investigational period.