Transfusion-related acute lung injury (TRALI) is one of several non-infectious hazards of transfusion that are receiving greater attention as a result of the blood banking community’s success in reducing many of the infectious risks of transfusion. Although some noninfectious risks, such as mistransfusion of an incompatible blood component, have always represented a clear and discernible risk to patients, the threat of TRALI has been less well appreciated because of challenges in diagnosis. TRALI is thought to be underrecognized and underreported, particularly in critically ill patients who have multiple additional risk factors for acute lung injury (ALI).

Currently, TRALI is the most commonly reported cause of transfusion-related death in the United States, surpassing deaths caused by ABO incompatibility and bacterial contamination.11 The actual incidence of TRALI remains unknown in the United States; however, with improved recognition, the number...

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