Recipient clinical risk factors predominate in possible transfusion-related acute lung injury

Pearl Toy, Peter Bacchetti, Barbara Grimes, Ognjen Gajic, Edward L. Murphy, Jeffrey L. Winters, Michael A. Gropper, Rolf D. Hubmayr, Michael A. Matthay, Gregory Wilson, Monique Koenigsberg, Deanna C. Lee, Nora V. Hirschler, Clifford A. Lowell, Randy M. Schuller, Manish J. Gandhi, Philip J. Norris, David C. Mair, Rosa Sanchez Rosen, Mark R. Looney

Research output: Contribution to journalArticle

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Abstract

Background: Possible transfusion-related acute lung injury (pTRALI) cases by definition have a clear temporal relationship to an alternative recipient risk factor for acute respiratory distress syndrome (ARDS). We questioned whether transfusion factors are important for the development of pTRALI. Study Design and Methods: In this nested case-control study, we prospectively identified 145 consecutive patients with pTRALI and randomly selected 163 transfused controls over a 4-year period at the University of California at San Francisco and the Mayo Clinic (Rochester, Minnesota). Results: For pTRALI, we found evidence against transfusion being important: receipt of plasma from female donors (odds ratio [OR], 0.82; 95% confidence interval [CI], 0.29-2.3; p = 0.70), total number of units transfused (OR, 0.99; 95% CI, 0.89-1.10; p = 0.86), and number of red blood cell and whole blood units transfused (OR, 0.78; 95% CI, 0.59-1.03; p = 0.079). In contrast, we found that risk for pTRALI was associated with additional recipient factors: chronic alcohol abuse (OR, 12.5; 95% CI, 2.8-55; p < 0.001), current smoker (OR, 4.2; 95% CI, 1.67-10.8; p = 0.0024), shock before transfusion (OR, 4.6; 95% CI, 2.0-10.7; p < 0.001), and positive fluid balance before transfusion (OR, 1.32/L; 95% CI, 1.20-1.44; p < 0.001). Conclusion: Recipient risk factors for ARDS rather than transfusion risk factors predominate in pTRALI.

Original languageEnglish (US)
Pages (from-to)947-952
Number of pages6
JournalTransfusion
Volume55
Issue number5
DOIs
StatePublished - May 1 2015
Externally publishedYes

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Acute Lung Injury
Odds Ratio
Confidence Intervals
Adult Respiratory Distress Syndrome
Water-Electrolyte Balance
San Francisco
Alcoholism
Case-Control Studies
Shock
Erythrocytes
Tissue Donors

ASJC Scopus subject areas

  • Hematology
  • Immunology
  • Immunology and Allergy

Cite this

Toy, P., Bacchetti, P., Grimes, B., Gajic, O., Murphy, E. L., Winters, J. L., ... Looney, M. R. (2015). Recipient clinical risk factors predominate in possible transfusion-related acute lung injury. Transfusion, 55(5), 947-952. https://doi.org/10.1111/trf.12954

Recipient clinical risk factors predominate in possible transfusion-related acute lung injury. / Toy, Pearl; Bacchetti, Peter; Grimes, Barbara; Gajic, Ognjen; Murphy, Edward L.; Winters, Jeffrey L.; Gropper, Michael A.; Hubmayr, Rolf D.; Matthay, Michael A.; Wilson, Gregory; Koenigsberg, Monique; Lee, Deanna C.; Hirschler, Nora V.; Lowell, Clifford A.; Schuller, Randy M.; Gandhi, Manish J.; Norris, Philip J.; Mair, David C.; Sanchez Rosen, Rosa; Looney, Mark R.

In: Transfusion, Vol. 55, No. 5, 01.05.2015, p. 947-952.

Research output: Contribution to journalArticle

Toy, P, Bacchetti, P, Grimes, B, Gajic, O, Murphy, EL, Winters, JL, Gropper, MA, Hubmayr, RD, Matthay, MA, Wilson, G, Koenigsberg, M, Lee, DC, Hirschler, NV, Lowell, CA, Schuller, RM, Gandhi, MJ, Norris, PJ, Mair, DC, Sanchez Rosen, R & Looney, MR 2015, 'Recipient clinical risk factors predominate in possible transfusion-related acute lung injury', Transfusion, vol. 55, no. 5, pp. 947-952. https://doi.org/10.1111/trf.12954
Toy, Pearl ; Bacchetti, Peter ; Grimes, Barbara ; Gajic, Ognjen ; Murphy, Edward L. ; Winters, Jeffrey L. ; Gropper, Michael A. ; Hubmayr, Rolf D. ; Matthay, Michael A. ; Wilson, Gregory ; Koenigsberg, Monique ; Lee, Deanna C. ; Hirschler, Nora V. ; Lowell, Clifford A. ; Schuller, Randy M. ; Gandhi, Manish J. ; Norris, Philip J. ; Mair, David C. ; Sanchez Rosen, Rosa ; Looney, Mark R. / Recipient clinical risk factors predominate in possible transfusion-related acute lung injury. In: Transfusion. 2015 ; Vol. 55, No. 5. pp. 947-952.
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abstract = "Background: Possible transfusion-related acute lung injury (pTRALI) cases by definition have a clear temporal relationship to an alternative recipient risk factor for acute respiratory distress syndrome (ARDS). We questioned whether transfusion factors are important for the development of pTRALI. Study Design and Methods: In this nested case-control study, we prospectively identified 145 consecutive patients with pTRALI and randomly selected 163 transfused controls over a 4-year period at the University of California at San Francisco and the Mayo Clinic (Rochester, Minnesota). Results: For pTRALI, we found evidence against transfusion being important: receipt of plasma from female donors (odds ratio [OR], 0.82; 95{\%} confidence interval [CI], 0.29-2.3; p = 0.70), total number of units transfused (OR, 0.99; 95{\%} CI, 0.89-1.10; p = 0.86), and number of red blood cell and whole blood units transfused (OR, 0.78; 95{\%} CI, 0.59-1.03; p = 0.079). In contrast, we found that risk for pTRALI was associated with additional recipient factors: chronic alcohol abuse (OR, 12.5; 95{\%} CI, 2.8-55; p < 0.001), current smoker (OR, 4.2; 95{\%} CI, 1.67-10.8; p = 0.0024), shock before transfusion (OR, 4.6; 95{\%} CI, 2.0-10.7; p < 0.001), and positive fluid balance before transfusion (OR, 1.32/L; 95{\%} CI, 1.20-1.44; p < 0.001). Conclusion: Recipient risk factors for ARDS rather than transfusion risk factors predominate in pTRALI.",
author = "Pearl Toy and Peter Bacchetti and Barbara Grimes and Ognjen Gajic and Murphy, {Edward L.} and Winters, {Jeffrey L.} and Gropper, {Michael A.} and Hubmayr, {Rolf D.} and Matthay, {Michael A.} and Gregory Wilson and Monique Koenigsberg and Lee, {Deanna C.} and Hirschler, {Nora V.} and Lowell, {Clifford A.} and Schuller, {Randy M.} and Gandhi, {Manish J.} and Norris, {Philip J.} and Mair, {David C.} and {Sanchez Rosen}, Rosa and Looney, {Mark R.}",
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T1 - Recipient clinical risk factors predominate in possible transfusion-related acute lung injury

AU - Toy, Pearl

AU - Bacchetti, Peter

AU - Grimes, Barbara

AU - Gajic, Ognjen

AU - Murphy, Edward L.

AU - Winters, Jeffrey L.

AU - Gropper, Michael A.

AU - Hubmayr, Rolf D.

AU - Matthay, Michael A.

AU - Wilson, Gregory

AU - Koenigsberg, Monique

AU - Lee, Deanna C.

AU - Hirschler, Nora V.

AU - Lowell, Clifford A.

AU - Schuller, Randy M.

AU - Gandhi, Manish J.

AU - Norris, Philip J.

AU - Mair, David C.

AU - Sanchez Rosen, Rosa

AU - Looney, Mark R.

PY - 2015/5/1

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N2 - Background: Possible transfusion-related acute lung injury (pTRALI) cases by definition have a clear temporal relationship to an alternative recipient risk factor for acute respiratory distress syndrome (ARDS). We questioned whether transfusion factors are important for the development of pTRALI. Study Design and Methods: In this nested case-control study, we prospectively identified 145 consecutive patients with pTRALI and randomly selected 163 transfused controls over a 4-year period at the University of California at San Francisco and the Mayo Clinic (Rochester, Minnesota). Results: For pTRALI, we found evidence against transfusion being important: receipt of plasma from female donors (odds ratio [OR], 0.82; 95% confidence interval [CI], 0.29-2.3; p = 0.70), total number of units transfused (OR, 0.99; 95% CI, 0.89-1.10; p = 0.86), and number of red blood cell and whole blood units transfused (OR, 0.78; 95% CI, 0.59-1.03; p = 0.079). In contrast, we found that risk for pTRALI was associated with additional recipient factors: chronic alcohol abuse (OR, 12.5; 95% CI, 2.8-55; p < 0.001), current smoker (OR, 4.2; 95% CI, 1.67-10.8; p = 0.0024), shock before transfusion (OR, 4.6; 95% CI, 2.0-10.7; p < 0.001), and positive fluid balance before transfusion (OR, 1.32/L; 95% CI, 1.20-1.44; p < 0.001). Conclusion: Recipient risk factors for ARDS rather than transfusion risk factors predominate in pTRALI.

AB - Background: Possible transfusion-related acute lung injury (pTRALI) cases by definition have a clear temporal relationship to an alternative recipient risk factor for acute respiratory distress syndrome (ARDS). We questioned whether transfusion factors are important for the development of pTRALI. Study Design and Methods: In this nested case-control study, we prospectively identified 145 consecutive patients with pTRALI and randomly selected 163 transfused controls over a 4-year period at the University of California at San Francisco and the Mayo Clinic (Rochester, Minnesota). Results: For pTRALI, we found evidence against transfusion being important: receipt of plasma from female donors (odds ratio [OR], 0.82; 95% confidence interval [CI], 0.29-2.3; p = 0.70), total number of units transfused (OR, 0.99; 95% CI, 0.89-1.10; p = 0.86), and number of red blood cell and whole blood units transfused (OR, 0.78; 95% CI, 0.59-1.03; p = 0.079). In contrast, we found that risk for pTRALI was associated with additional recipient factors: chronic alcohol abuse (OR, 12.5; 95% CI, 2.8-55; p < 0.001), current smoker (OR, 4.2; 95% CI, 1.67-10.8; p = 0.0024), shock before transfusion (OR, 4.6; 95% CI, 2.0-10.7; p < 0.001), and positive fluid balance before transfusion (OR, 1.32/L; 95% CI, 1.20-1.44; p < 0.001). Conclusion: Recipient risk factors for ARDS rather than transfusion risk factors predominate in pTRALI.

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