Preventing TRALI at BBG

Breaking down acronyms with the experts who work with them day in and day out
April 22, 2019
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Samantha Gomez Ngamsuntikul, Associate Medical Director, oversees medical procedures, regulatory compliance and clinical trials at the South Texas Blood & Tissue Center. She answers the question “What is TRALI?”

TRALI stands for transfusion-related acute lung injury. It is a rare, sometimes deadly respiratory complication that occurs within six hours after receiving a blood transfusion. Symptoms include difficulty breathing, low oxygen levels and excess fluid in the lungs. 

According to current theory, TRALI occurs through a two hit process. The first part is an event like shock leading to activated neutrophils or white blood cells in the lungs. The second involves something in the transfusion setting off the activated white blood cells, such as donor antibodies to human leukocyte antigens or bioactive lipids.

Supportive treatment with oxygen and intravenous fluids are used to treat patients with TRALI. The condition, which was listed as the leading cause of transfusion deaths in the country from 2008-12, is now rare because of mitigation strategies.

BioBridge Global has measures in place for TRALI. Following American Association of Blood Banks (AABB) guidelines, women who have been pregnant have their blood tested for antibodies to human leukocyte antigens (HLA), which can be produced during pregnancy. HLA antibodies are found in between 10 and 20 percent of healthy, previously pregnant donors.

Our immunohematology reference lab at QualTex Laboratories tests donors for the presence of these antibodies. Donors are then informed by South Texas Blood & Tissue Center of the test results through a letter if they are positive for these antibodies. They can still donate whole blood or double red cells.


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