Age of blood and recipient factors determine the severity of transfusion-related acute lung injury (TRALI)

Tung, John-Paul; Fraser, John F; Nataatmadja, Maria; Colebourne, Kathryn I; Barnett, Adrian G; Glenister, Kristen M; Zhou, Anna Y; Wood, Peter; Silliman, Christopher C; Fung, Yoke L

doi:10.1186/cc11178

Critical Care

Table 1 Groups of sheep and incidence of TRALI

From: Age of blood and recipient factors determine the severity of transfusion-related acute lung injury (TRALI)

Group names	1^st event	2^nd event	n	Hypoxaemia	Pulmonary oedema	ALI/TRALI
						Number positive (% positive)
Sham	Saline	Saline	5	0	0	0 (0%)
Saline-fresh	Saline	"Fresh PRBC"	4	0	0	0 (0%)
Saline-stored	Saline	"Stored PRBC"	3	1	0	0 (0%)
LPS-control	LPS	Saline	6	0	2	0 (0%)
LPS-fresh	LPS	"Fresh PRBC"	5	1	1	1 (20%)
LPS-stored	LPS	"Stored PRBC"	5	5	4	4 (80%) ^a
Previous study [10]	LPS	"Fresh PLT" (d1-PLT-S/N)	5	2	3	1 (20%)
Previous study [10]	LPS	"Stored PLT" (d5-PLT-S/N)	5	4	5	4 (80%)

ALI, acute lung injury; d1-PLT-S/N, pooled heat-inactivated supernatant from Day 1 human platelet concentrates; d5-PLT-S/N, pooled heat-inactivated supernatant from Day 5 human platelet concentrates; "fresh PLT", pooled heat-inactivated supernatant from Day 1 human platelet concentrates; "fresh PRBC," pooled heat-inactivated supernatant from Day 1 human PRBC; LPS, lipopolysaccharide; n, number of sheep in group; "stored PLT", pooled heat-inactivated supernatant from Day 5 human platelet concentrates; "stored PRBC," pooled heat-inactivated supernatant from day 42 human packed red blood cell concentrates; TRALI, transfusion-related acute lung injury. Sheep were randomly assigned into the groups described above. Sheep were infused with either saline or LPS as a first event. Sheep were subsequently infused with saline, or transfused with either "fresh PRBC" or "stored PRBC" as a second event. TRALI was defined by the development of both hypoxaemia either during or within two hours of the second event transfusion, and pulmonary oedema upon blinded histological assessment of post- mortem lung sections. ^aLPS infusion as a first event followed by the subsequent transfusion of stored PRBC as the second event predisposed the sheep towards the development of TRALI (by Fisher's exact test: P = 0.01 LPS-stored vs. saline-fresh, saline-stored and LPS-fresh without post hoc exclusion, or P = 0.048 LPS-stored vs. LPS-fresh and P = 0.003 LPS-stored vs. saline-fresh, saline-stored and LPS-fresh with post hoc exclusion).

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