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Scott & White takes precautions to avoid TRALI

blood-unitBack in the 1980s and 90s, the big fear if you had a blood transfusion was getting HIV/AIDS.

Today, your risk of getting HIV from a blood transfusion is about 1 in 2 million. The blood supply has never been safer.

Now, the leading cause of transfusion-related death in the United States is TRALI – Transfusion-Related Acute Lung Injury. It’s a serious complication that may result from a blood transfusion. It’s potentially life threatening.

Walter J. Linz, MD, Medical Director of the Scott & White Blood Center and Transfusion Medicine, explains TRALI and details the precautions Scott & White Transfusion Services take to prevent it at Scott & White.

What Is TRALI?

“TRALI is acute shortness of breath related to transfusion with no other explanation,” says Dr. Linz.

In some cases, it can result in:

  • Acute respiratory distress requiring intubation
  • Death

What Causes TRALI?

TRALI is a condition that may occur when you’re transfused with plasma from a person who has anti-human leukocyte antigen (HLA) antibodies or anti-granulocyte specific antibodies.

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Generally, Dr. Linz explains, there are two populations who may have anti-HLA antibodies or anti-granulocyte antibodies:

  • Women who have had more than one child
  • Someone who has previously had a transfusion

In other words, the donated blood of women who have had multiple pregnancies and people who’ve received blood transfusions in the past may have anti-HLA antibodies that may cause an antibody-antigen reaction in the transfusion recipient, resulting in TRALI.

Preventing TRALI

“All blood products wherever possible at Scott & White are TRALI-safe. That’s something we’ve done for several years and have been ahead of many other hospitals on,” says Dr. Linz.

The single best way to prevent TRALI is by ensuring patients do not receive plasma or platelets with anti-HLA antibodies.

Plasma. Because anti-HLA antibodies are primarily found in the blood of women with multiple children and people who have previously been transfused, it’s the policy of the Scott & White Blood Center that we do not use plasma from these populations, with the exception of the rare AB type, says Dr. Linz.

“For example, if someone who comes to our donor center and has had three pregnancies, that plasma will not be used for transfusion purposes. The red cells will — the red cells are just fine — but the plasma won’t be,” explains Dr. Linz.

As a result, the plasma supply at Scott & White Healthcare is secure.

Platelets. Similarly, “if someone comes in to give platelets, we’ll test them for HLA. It doesn’t matter how many pregnancies. If they’re negative, we’ll collect their platelets. If they’re positive,” Dr. Linz says, “we won’t let them be a platelet donor.”

“The safety of our transfusion patients is paramount,” Dr. Linz says.

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Scott & White takes precautions to avoid TRALI