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Ready to upload
Record number:
1484
Adverse Occurrence type:
MPHO Type:
Estimated frequency:
Data from patient populations prone to develop TRALI showed a significant reduction of TRALI risk (OR, 0.51; 95% CI, 0.29-0.90), while data from general patient populations showed a similar non-significant trend (OR, 0.66; 95% CI, 0.40-1.09).
Alerting signals, symptoms, evidence of occurrence:
A meta-analysis was performed to determine whether use of low risk TRALI donor strategies for plasma indeed reduces onset of TRALI. Ten articles were reviewed. Two reviewers independently extracted data on study characteristics, methods and outcomes. Primary endpoint was onset of TRALI. Subgroup analyses were performed for patient populations prone to develop TRALI and general patient populations.
Demonstration of imputability or root cause:
Ten articles were included. Meta-analysis using a random-effects model taking into account all transfused products showed a significant reduction for the risk of TRALI after implementation of low-risk TRALI donor strategies (odds ratio [OR], 0.61; 95% confidence interval [CI], 0.42-0.88). Data from patient populations prone to develop TRALI showed a significant reduction of TRALI risk (OR, 0.51; 95% CI, 0.29-0.90), while data from general patient populations showed a similar non significant trend (OR, 0.66; 95% CI, 0.40-1.09). Results were similar when taking only plasma products into account (OR, 0.62; 95% CI, 0.42-0.92). The introduction of low-risk TRALI donor strategies for plasma-containing products results in a reduction of TRALI.
Imputability grade:
3 Definite/Certain/Proven
Groups audience:
Keywords:
Reference attachment:
Suggest references:
Müller MC, van Stein D, Binnekade JM, van Rhenen, D.J. and Vlaar, A.P. (2015). Low-risk transfusion-related acute lung injury donor strategies and the impact on the onset of transfusion-related acute lung injury: a meta-analysis. Transfusion 55(1):164-175.
Expert comments for publication:
This article reviews the strategies for reducing the risk of TRALI selecting donors with lower risk of HLA antibodies in their plasma such as male only donors.