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XLI - Pulmonary edema - Acute lung injury - ARDS

Transfusion-related acute lung injury (TRALI) (May cause ARDS)

Last update 17/06/2026

(Fr: OAP transfusionnel. A distinguer de l'OAP de surcharge). TRALI is a distinctive form of ARDS or NCPE (see under IIa, IIb) due to transfusion/infusion of allogeneic blood, platelets, stem-/marrow cells, IVIG or FFP. Typically, TRALI develops within 6-8h of transfusion. Examination of each donor in the pool (more often a multiparous woman) for the presence of pathogenic antibodies to a cognate Ab in the recipient is indicated to prevent further TRALI in other recipents, and the bloodbank shoulb be notified. The syndrome is underappreciated and is amenable to risk reduction strategies (e.g. men-only donor poliicy, Ab screening). TRALI (PMID 25611652) must me differentiated from TACO (Transfusion Associated Circulatory Overload: PMID 17898575, 24360126, 25611653). Predisposing risk factos may account for posttransfusion ARDS also known as 'possible TRALI' (PMID 25488517). Prevention at PMID 30197000

Causative drugs

Frequency - Incidence

Incidence of respiratory adverse event(s) due to the specific drug as assessed by number of reported/published cases in the literature. Red digits in stars indicate: 0 = Very rare, questionable signal · 1 = < 10 cases · 2 = 10-50 cases · 3 = 50–100 cases · 4 = 100-200 cases · 5 = >200 cases