Transfusion Related Acute Lung Injury (TRALI)

Blood Transfusion

Purpose

TRALI is a serious complication of transfusion which usually occurs within 6 hours of a transfusion episode, characterised by signs and symptoms of dyspnoea, cyanosis, hypoxaemia and pulmonary oedema, and in the absence of other causes such as cardiac insufficiency and fluid overload. TRALI is a diagnosis made by exclusion where other causes are not apparant and there has been a recent transfusion of blood or plasma.

Notes

• Requires Consultant Haematologist approval
• Histocompatibility & Immunogenetics Diagnostic Laboratory Form 3A required to request this test (form available from Transfusion laboratory or available using the link below)
• Test is performed at NHSBT Filton, Bristol
• Sample must be < 24hrs from bleed date
• Samples must NOT be refrigerated
• The following factors are known to significantly affect the performance of the examination or the interpretation of the results: lipaemia, sample clotted (if EDTA), haemolysed. Any sample displaying these factors cannot be processed and will be rejected

H&I Request Form (3A) - Platelet Refractoriness / Transfusion Reactions

Sample requirements

6 mL EDTA tube

AND

6mL plain gel tube for serum samples

The request form and sample must be labelled with

• Surname
• First Name
• Date of Birth
• NHS (or Hospital Number, if NHS number not available)

The sample must be labelled, signed and dated by the person taking the blood

The sample tube must be in date

Unlabelled, incorrectly, altered or inadequately labelled samples will not be accepted. No specimen is considered unrepeatable.

Refer to H&I Requirements for Sample Labelling and Request Form Completion