Processing Of Blood Components Research Articles

Produksi Komponen Darah Packed-Red Cell (PRC), Liquid Plasma (LP), Thombocytes Concentrates (TC) dan Fresh-Frozen-Plasma (FFP) di UDD PMI Kabupaten Bojonegoro

The processing of blood components is an act of separating the components of donor blood through a process by taking into account the quality and safety of blood component products. Its process produce various type of blood component, such as Packed Red Cell, Liquid Plasma, Thrombocytes Concentrate and Fresh Frozen Plasma. The quantity of each blood production depends on the mount of demant from hospital to threat the patient for transfusion. Indonesia Red Cross especially in Blood Donor Unit of each region have a important duty to collect and process the whole blood component as much as it needed. This type of research is a descriptive study with a cross sectional approach. The population used was the production of PRC, LP, TC and FFP Â at UDD PMI Bojonegoro from June to July 2022 as many as 2124 kolf. The sampling technique used purposive sampling. Data analysis using univariate analysis which is presented in the form of a frequency distribution table and ghraphic for daily production. Production of blood components as much as 2124 kolf, Production of PRC as 984 kolf (46%), LP as 904 kolf (43%0, TC as 200 kolf (9%), and FFP as 36 kolf (2%). The highest blood component production is PRC, followed by LP, TC and FFP, respectfully. Â

Blood donation practices, processing and utilisation of blood components in government tertiary hospitals in Nigeria: a multicentre cooperative study.

Timely access to safe blood and blood components is still a challenge in Nigeria. This study aimed to determine blood donation practices, processing and utilization of blood components across government tertiary hospitals (THs) in Nigeria. This was a descriptive cross-sectional study done in Nigeria in June-July 2020. Data were analysed with SPSS version 21.0. Data were collected from 50 THs. The majority (68%) of the THs lack facilities for blood component preparation and only 18% and 32% provide cryoprecipitate and platelet concentrate, respectively. Whole blood was most commonly requested (57.04%). All facilities tested blood for HIV, HBV and HCV, but the majority (23 [46%]) employed rapid screening tests alone and nucleic acid testing was not available in any hospitals. The manual method was the most common method of compatibility testing in 90% (45/50) and none of the THs routinely perform extended red cell typing. The average time to process routine, emergency and uncross-matched requests were a mean of 109.58±79.76min (range 45.00-360.00), 41.62±25.23 (10.00-240.00) and 11.09±4.92 (2.00-20.00), respectively. Facilities for blood component preparation were not widely available. Concerned government authorities should provide facilities for blood component preparation.

KEY FACTORS FOR SAFE AND RATIONAL SECURITY OF BLOOD AND BLOOD COMPONENTS

The use of human blood for therapeutic purposes requires the continuous construction of safety and quality systems, in order to minimize potential risks during the process of collection, processing, circulation and final use. Safety, security, rationality, and reliability are important prerequisites for the continuous provision of blood products, regardless of their purpose. Health institutions for blood and blood products should have an organized quality system that will be compatible with strategic goals, while at the same time emphasizing the self-sufficiency of a particular community. In this context, it is necessary to establish a stable and applicable mechanism for issuing permits and accreditation by certified institutions, from this field, which would ensure their operation in accordance with current regulations. Modern blood transfusion practice must provide guarantees to voluntary blood donors regarding the security and confidentiality of all data related to the health of each individual. The key factors, on which safe and rational provision of blood and blood products are based, are visible through continuous activities associated with the promotion of voluntary and unpaid blood donation, thus contributing, in a specific way, to raising and maintaining high standards. Medical and other personnel involved in the process of collection, examination, processing, storage and circulation of human blood and blood components should be qualified and should undergo continuous education. The future development of transfusiology will be based on teamwork and interdisciplinary cooperation, as well as continuous monitoring and application of regulations from this field. The implementation of the Type and Screen method, i.e., blood group typing and antibody screening, should become a standard in the rationalization of the need for blood, which ensures a greater number of available blood units, increases self-sufficiency and directly contributes to the preservation of the health of donors and recipients of blood and blood components.

Transfusion of target antigens to preimmunized recipients: a new mechanism in transfusion-related acute lung injury

AbstractTransfusion-related lung injury (TRALI) is a serious side effect of blood transfusion. Exclusion of antibody carriers from the donor pool has significantly decreased the number of cases, but TRALI remains the leading cause of transfusion-related morbidity and mortality in industrialized countries. Here, we show that proteins released from donor cells during processing of blood components are capable of inducing a new type of reverse TRALI when transfused to preimmunized recipients. First, we show that soluble neutrophil surface protein CD177 in complex with proteinase 3 (sCD177/PR3) is not only present in human plasma but also in packed red blood cell (PRBC) supernatant. Filtration or storage enhances the concentration of sCD177/PR3 in PRBCs. Second, we show that sCD177/PR3 specifically binds to PECAM-1 on stimulated (but not on unstimulated) endothelial cells (ECs). Third, we provide evidence that the sCD177/PR3/PECAM-1 complex is functional. In the presence of monoclonal or human antibodies against CD177 or PR3, ECs produce reactive oxygen species and become apoptotic. Albumin flux through an EC monolayer increases significantly whenever antibodies and the cognate antigens are present. Finally, we describe a clinical case in which anti-CD177 present in a transfusion recipient precipitated TRALI after the transfusion of CD177-positive, but not CD177-negative, PRBCs. In conclusion, we introduce a new TRALI mechanism based on the specific binding of transfused, soluble antigens to activated ECs in preimmunized recipients. We suggest that further studies and clinical work-up of TRALI should also include antibody investigation of the recipient.

The 'rejuvenating factor' TIMP-2 is detectable in human blood components for transfusion.

Background and ObjectivesTissue inhibitor of metalloproteinases 2 (TIMP‐2) is a protein suspected to be crucial in numerous physiological and pathological processes such as morphogenesis, tissue remodelling and metastasis suppression. In animal models, the administration of TIMP‐2 to aged mice improved their cognitive functions. Therefore, one can hypothesize that differences in TIMP‐2 levels between blood donors and recipients might influence cognitive functions also in humans. However, the stability of TIMP‐2 during processing and storage of blood components for transfusion has not been intensively investigated so far. This study determined TIMP‐2 concentrations in fresh‐frozen plasma (FFP), erythrocyte concentrate (EC) and pathogen‐inactivated platelet concentrate (PI‐PC) depending on the donor's demographic factors age and gender.Materials and MethodsTissue inhibitor of metalloproteinases 2 was measured in FFP (n = 30), EC (n = 12) and PI‐PC (n = 12) using a Q‐Plex single‐plex immunoassay for chemiluminescence‐based detection. Absolute quantification of TIMP‐2 was performed with Q‐view software. Fresh umbilical cord plasma was used as a positive control.ResultsTissue inhibitor of metalloproteinases 2 was detected in FFP (30/30 samples), EC (11/12 samples) and PI‐PC (12/12 samples). The median TIMP‐2 concentration in EC (17·2 ng/ml; range: 0–26·5 ng/ml) was significantly lower compared with FFP (63·4 ng/ml; range: 44·4–87·3 ng/ml) or PI‐PC (69·9 ng/ml; range: 39·9–83·6 ng/ml). Across all blood components, TIMP‐2 levels are comparable in male and female donors and independent of age.ConclusionTissue inhibitor of metalloproteinases 2 is detectable and stable in FFP, PI‐PC and, in low concentration, EC. It can be hypothesized that TIMP‐2 will be transmitted to recipients during transfusion.

Організація та державне регулювання діяльності служби крові в Україні

Організація та державне регулювання діяльності служби крові в Україні

Transfusion-transmitted cytomegalovirus: behaviour of cell-free virus during blood component processing. A study on the safety of labile blood components in Switzerland.

Nowadays, most blood products are leukocyte-reduced. After this procedure, the residual risk for transfusion transmitted cytomegalovirus (TT-CMV) is mostly attributed to cell-free viruses in the plasma of blood donors following primary infection or viral reactivation. Here, objectives are: 1) to study the behaviour of cell-free CMV through the blood component processing; 2) to determine the anti-CMV seroprevalence, the level of viremia, the window-period in blood donor population; and 3) to identify cases of TT-CMV in bone marrow transplant (BMT) recipients. Cell-free CMV was injected into blood bags originating from regular donors. Blood components were processed according to either the CompoSelect® or the CompoFlow® (Fresenius Kabi AG) techniques. Samples were analysed at each step for presence of virus DNA using quantitative polymerase chain reaction (PCR). The anti-CMV seroprevalence in our donor population was taken from our donor data system. The viremia was assessed in pooled plasmas samples from routine donations by quantitative PCR. Medical charts of 165 BMT anti-CMV seronegative recipients/anti-CMV seronegative donors who received CMV-unscreened blood products were reviewed. Cell-free CMV passes without any decrease in viral load through all stages of blood processing. The anti-CMV seroprevalence was 46.13%. Four DNA positive samples out of 42,240 individual blood donations were identified (0.009%); all had low levels of viremia (range 11-255 IU/mL). No window-period donation was identified. No TT-CMV was found. Cell-free CMV remains a concern with current blood component processing as it passes through all the processes. However, since low levels of CMV DNA were identified in the donations tested, and no BMT recipients had TT-CMV, the residual threat of TT-CMV after leukocyte reduction appears to be very low.

Quantitation of Cell-Derived Microparticles in Blood Products and Its Potential Applications in Transfusion Laboratories.

Cell-derived microparticles (MPs) are small fragments released from various cells when they are activated or undergo apoptosis. In the field of transfusion medicine, a number of studies have documented increased levels of MPs in blood products, which have been associated with multiple factors, including donor variability, blood component processing, and storage. In addition, transfusions that contain high levels of MPs are linked to posttransfusion complications. Considering the clinical importance of MP levels, transfusion laboratories should routinely screen blood products for them. However, this practice is not yet applied routinely, perhaps in part because of a lack of understanding of how to apply MP data to transfusion medicine. We describe the methods used to quantitate MPs in blood components and discuss the application of these quantitative data in routine transfusion laboratories in order to manage quality, improve the outcomes of transfusions, and minimize their complications.

Seroprevalence and trends in transfusion transmitted infections in blood donors: a 6-year experience in a tertiary care hospital

Introduction: Blood transfusion continues to be a possible source of pathogens in transfused patients. The pattern of transfusion-transmitted infections (TTI) varies between regions. Knowledge of prevalence of TTIs is essential to monitor safety of blood transfusion by ensuring better practices of collection and processing of blood components. The aim of the study was to determine the prevalence of TTI in blood donors in a tertiary care hospital in central India. Materials and Methods: A retrospective cross sectional study was performed from 2012 to 2017 in a tertiary care government hospital in central region of India. The study analyzes all voluntary and replacement blood donations received through the hospital in its blood bank and blood donation camps organized by the hospital. Results:A total of 54,831 units of blood was collected over a period of 6 years. Prevalence of TTI in the blood donors was 1.45%. Prevalence of seroprevalence of human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), syphilis and malaria were 0.31 %, 0.75%, 0.065%, 0.22% and 0.1% respectively. Among all the potential donors, the most common TTI prevalence was that of Hepatitis B followed by HIV and syphilis. Conclusion:Public awareness, careful donor selection,vigilant screening and adoption of newer techniques for inactivation of pathogens are needed to ensure safety of blood products and their transfusion.The public outreach programs such as blood donation camps could be used as a way of spreading awareness to improve the safety and efficacy of a blood donation program.

Reflections on the dynamics of bacterial and viral contamination of blood components and the levels of efficacy for pathogen inactivation processes

Blood transfusion safety has been increasingly improving during the past two decades. However, threats from both known and emerging pathogens require continual improvement and re-assessment of blood safety measures. In this respect, we are currently witnessing the broader implementation of Pathogen reduction technology (PRT) for blood complements. These methods, combined with existing safety measures, have helped to reduce the pathogen risks of transfusion-transmitted infections. Currently multiple reviews have compared levels of inactivation between different commercialized PRTs. However, to analyze levels of pathogen inactivation, it is necessary to understand the dynamics of infectivity as well as the modes of disease transmission by blood transfusion for various pathogens. It is well known that contributing variables include donor characteristics through the processing of blood components to ultimately the recipient characteristics, which create enormous variability in overall outcomes relative to disease transmission. The aim of this paper is to discuss bacterial and viral contamination of blood components in order to determine adequate levels of efficacy and subsequent disease transmission safety of current pathogen inactivation protocols that are designed to reduce the risk of transfusion-transmitted infections. In such a conceptual analysis, however, it is important to understand several contributing factors including the measurement of pathogen load in blood products and the dynamics, infectivity and disease transmission of various pathogens via transfusion of blood components and products. In many cases, the log reduction values observed do not truly reflect the extent of reduction in the levels of infectivity that are observed clinically. Results from clinical trials and hemovigilance programs upon routine implementation of PRT methods provide a more direct insight into effectiveness with regard to clinical relevance of in vitro spiking studies. These issues are briefly addressed in this manuscript.

Effects of donor age, donor sex, blood-component processing, and storage on cell-derived microparticle concentrations in routine blood-component preparation

BackgroundA number of factors cause increases in the number of cell-derived microparticles (MPs) in blood components. However, the overall effects of these factors on the concentration of MPs during routine blood-component preparation have not fully been elucidated. AimTo evaluate the effects of donor age, donor sex, blood-component preparation, and storage on MP concentrations. MethodsFlow cytometry was used to quantitate the number of whole blood-derived MPs. ResultsThe total MP concentration was similar in male and female donors (26,044 ± 1254 particles/μL vs. 27,696 ± 1584 particles/μL). The total MP concentration did not differ significantly among the different age groups: 18–30 years (28,730 ± 1600 particles/μL), 31–40 years (24,972 ± 5947 particles/μL), and 41–58 years (25,195 ± 1727 particles/μL). However, the total number of MPs in fresh plasma (152,110 ± 46,716 particles/μL) was significantly higher (p < 0.05) than that in unprocessed whole blood (26,752 ± 985 particles/μL), fresh packed red blood cells (PRBCs) (28,574 ± 1028 particles/μL), and platelet concentrate (PC) (33,072 ± 1858 particles/μL). Furthermore, the total numbers of MPs in stored PRBCs and fresh-frozen plasma (FFP) were significantly higher (p < 0.05) than those in fresh PRBCs and fresh plasma, respectively. ConclusionsThe study suggests that donor factors, blood-component processing and storage contribute to the MP concentration in routine blood-product preparation. The findings can improve quality control and management of blood-product manufacturing in routine transfusion laboratories.

La transfusion au Maroc : mise au point sur la réglementation

Transfusion is currently framed by extremely reassuring scientific rules and references. The actors intervening at these different stages must know the requirements relating to their practice at the risk of having their liability incurred, or that of the establishment where they work, in case of damage caused to the patient due to the absence of their respect. The law No. 03-94 on the donation, collection and use of blood and the texts adopted for its application require the finalization of the legislative and regulatory requirements for transfusion in Morocco. It encourages the donation of anonymous, voluntary unpaid blood donations and envisages many provisions for the prospective blood donor eligibility, the blood collection, the testing, processing, storage, transport, distribution and issuing of blood and blood components and the haemovigilance. This article will provide an update on the Moroccan regulation of the entire transfusion process from prescription to follow-up of the recipient, limited to the use of labile blood products. Its objective is to identify the main regulatory requirements in order to adapt the same level of knowledge of the personnel and to control them in spite of a difficult environment and in the respect of the rights of patients with regard to the benefits and consequences of the transfusion act.

The "Aging Factor" Eotaxin-1 (CCL11) Is Detectable in Transfusion Blood Products and Increases with the Donor's Age.

Background: High blood levels of the chemokine eotaxin-1 (CCL11) have recently been associated with aging and dementia, as well as impaired memory and learning in humans. Importantly, eotaxin-1 was shown to pass the blood-brain-barrier (BBB) and has been identified as crucial mediator of decreased neurogenesis and cognitive impairment in young mice after being surgically connected to the vessel system of old animals in a parabiosis model. It thus has to be assumed that differences in eotaxin-1 levels between blood donors and recipients might influence cognitive functions also in humans. However, it is unknown if eotaxin-1 is stable during processing and storage of transfusion blood components. This study assesses eotaxin-1 concentrations in fresh-frozen plasma (FFP), erythrocyte concentrate (EC), and platelet concentrate (PC) in dependence of storage time as well as the donor’s age and gender.Methods: Eotaxin-1 was measured in FFP (n = 168), EC (n = 160) and PC (n = 8) ready-to-use for transfusion employing a Q-Plex immunoassay for eotaxin-1. Absolute quantification of eotaxin-1 was performed with Q-view software.Results: Eotaxin-1 was consistently detected at a physiological level in FFP and EC but not PC. Eotaxin-1 levels were comparable in male and female donors but increased significantly with rising age of donors in both, FFP and EC. Furthermore, eotaxin-1 was not influenced by storage time of either blood component. Finally, eotaxin-1 is subject to only minor fluctuations within one donor over a longer period of time.Conclusion: Eotaxin-1 is detectable and stable in FFP and EC and increases with donor’s age. Considering the presumed involvement in aging and cognitive malfunction, differences in donor- and recipient eotaxin-1 levels might affect mental factors after blood transfusion.

How to reverse first time donors to become regular donors? A questionnaire survey in Estonia

BackgroundDonating blood in Estonia is non-remunerated and voluntary. Estonian Blood Service system has four independent regional blood centres that are responsible for blood collection, processing, screening and distribution of blood components to hospitals for clinical use. Study designThis research was carried out as a questionnaire survey. A questionnaire was developed to study lapsing first time donors’ (FTD) blood donation experience, intention and willingness to donate again. MethodsA thousand five hundred and forty-six questionnaires were posted to donors who had one successful donation in 2010 and who had not returned to second donation till the year 2012. For data analysis routine statistical methods were used. To evaluate the most appropriate number of classes, based on previous experience and future expectations, latent class analysis was used. ResultsThere were 453 respondents (29.3%). For the majority of aspects of blood donation experience the emotions were positive. Results of the study suggested that blood collection agencies should intervene to bolster donors’ attitudes, perceived control, and identity as a donor during this crucial post-first donation period. ConclusionFirst blood donation seems to have been a positive experience. Reasons leading to stopping blood donation should be studied further. Establishing a donor registry for Estonia would be essential to keep track of donors.

Redefining the role of blood establishments as raw material suppliers, manufacturers, and distributors for new cell therapies: the Blood Systems experience.

Redefining the role of blood establishments as raw material suppliers, manufacturers, and distributors for new cell therapies: the Blood Systems experience.

Processing and storage of blood components: strategies to improve patient safety

Processing and storage of blood components: strategies to improve patient safety Ruby NI Pietersz, Pieter F van der Meer Department of Product and Process Development, Sanquin Blood Bank, Amsterdam, the Netherlands Abstract: This review focuses on safety improvements of blood processing of various blood components and their respective storage. A solid quality system to ensure safe and effective blood components that are traceable from a donor to the patient is the foundation of a safe blood supply. To stimulate and guide this process, National Health Authorities should develop guidelines for blood transfusion, including establishment of a quality system. Blood component therapy enabled treatment of patients with blood constituents that were missing, only thus preventing reactions to unnecessarily transfused elements. Leukoreduction prevents many adverse reactions and also improves the quality of the blood components during storage. The safety of red cells and platelets is improved by replacement of plasma with preservative solutions, which results in the reduction of isoantibodies and plasma proteins. Automation of blood collection, separation of whole blood into components, and consecutive processing steps, such as preparation of platelet concentrate from multiple donations, improves the consistent composition of blood components. Physicians can better prescribe the number of transfusions and therewith reduce donor exposure and/or the risk of pathogen transmission. Pathogen reduction in cellular blood components is the latest development in improving the safety of blood transfusions for patients. Keywords: blood components, red cell concentrates, platelet concentrates, plasma, transfusion, safety&nbsp

Audit of clinical-laboratory practices in haematology and blood transfusion at Muhimbili National Hospital in Tanzania

In Tanzania, there is paucity of data for monitoring laboratory medicine including haematology. This therefore calls for audits of practices in haematology and blood transfusion in order to provide appraise practice and devise strategies that would result in improved quality of health care services. This descriptive cross-sectional study which audited laboratory practice in haematology and blood transfusion at Muhimbili National Hospital (MNH) aimed at assessing the pre-analytical stage of laboratory investigations including laboratory request forms and handling specimen processing in the haematology laboratory and assessing the chain from donor selection, blood component processing to administration of blood during transfusion. A national standard checklist was used to audit the laboratory request forms (LRF), phlebotomists' practices on handling and assessing the from donor selection to administration 6f blood during transfusion. Both interview and observations were used. A total of 195 LRF were audited and 100% of had incomplete information such as patients' identification numbers, time sample ordered, reason for request, summary of clinical assessment and differential diagnoses. The labelling of specimens was poorly done by phlebotomists/clinicians in 82% of the specimens. Also 65% (132/202) of the blood samples delivered in the haematology laboratory did not contain the recommended volume of blood. There was no laboratory request form specific for ordering blood and there were no guidelines for indication of blood transfusion in the wards/ clinics. The blood transfusion laboratory section was not participating in external quality assessment and the hospital transfusion committee was not in operation. It is recommended that a referral hospital like MNH should have a transfusion committee to provide an active forum to facilitate communication between those involved with transfusion, monitor, coordinate and audit blood transfusion practices as per national guidelines.

Influence of multicomponent apheresis on donors’ haematological and coagulation parameters, iron storage and platelet function

Multicomponent collection (MCC) enables production and processing of various blood components during one apheresis session. In this prospective crossover study, the effects of donating platelets (PLTs) and packed red blood cells (PRBCs) on donor's blood cell count, coagulation, PLT function and iron state were analysed. Forty-eight MCCs were performed using two different cell separators (Fenwal Amicus(®), CaridianBCT Trima Accel(®)). Two units of platelet concentrates and one unit of PRBCs were collected during each session. Full blood cell count and iron status were obtained on day 0 before and after apheresis, day 2, day 14 and day 42. PLT function was analysed by aggregometry and rotation thromboelastometry in parallel with coagulation tests before and after MCC and at day 2. Multicomponent collection was well tolerated without adverse side effects. Blood cell count and iron parameters declined and most of them (haemoglobin, haematocrit, transferrin, transferrin saturation and ferritin) were significantly below baseline values until at least day 42 after donation. Absent iron stores were seen in 31·3% of the donors. In contrast, PLTs significantly exceeded pre-donation values after 14 days and remained significantly increased for 42 days. After 2 days, coagulation parameters were only slightly (P > 0·05) altered, whereas PLT function was significantly reduced. Multicomponent collection is an obviously safe procedure; however, the significant long-term impact on the donor's blood count and iron store, as well as impaired PLT function, has to be considered in regard to donor safety.

Effect of pathogen inactivation on the storage lesion in red cells and platelet concentrates

A primary function of blood transfusion services is to ensure the safety of the community’s blood supply. Multilayer strategies of safety need to be incorporated into the processing of blood components in order to minimize untoward transfusion events related to infections or the blood storage lesion. While there have been considerable technical advances over the past few decades to advance blood component safety, there is a need for continued improvement. One significant problem area is transfusion transmitted bacterial infections. In infectious disease, blood borne bacteria are the major cause of morbidity in transfusion medicine. Proactive implementation of pathogen inactivation technologies, PIT can help to eliminate bacterial contamination of blood. This is accomplished by inactivation of various known and emerging bacterial pathogens, which have been identified through their nucleic acid sequences. The current PIT has additional positive impacts on transfusion safety by reducing adverse clinical events associated with viable residual leukocytes in the blood. Given the valuable benefits of pathogen inactivation, there is a practicable need to advance this technology. In order for a particular pathogen inactivation strategy to gain widespread acceptance, it must satisfy a number of important criteria. The technology shall be: (1) Effective to eliminate pathogens. (2) Uncomplicated and cost-effective to implement in the preparation of blood components. (3) Minimally toxic while maintaining the quality of blood storage products for transfusion purposes. (4) Safe. Currently, PIT is not suitable for all blood components. Future advances in PIT for whole blood and red cell components should expand the application of this technology across a broader range of blood products. Based on available laboratory and clinical data, current pathogen inactivation procedures appear to leave the cell components sufficiently viable to achieve an effective transfusion. Novel technologies continue to evolve for the inactivation of pathogens in the blood supply. We need to ensure these procedures do not worsen the storage lesion causing potential harm to patients. Quality research and development supporting multi-centre clinical trials are necessary. One purpose of such trials is to determine whether this new generation of procedures for processing blood yields bioequivalency regarding the quality of the products. Validated haematological assays should be utilized to test the extent of the blood storage lesion. Post-marketing surveillance involving active haemovigilance is necessary regarding possible adverse outcomes of transfusion.

Le conflit immunologique dans l’œdème pulmonaire lésionnel aigu post-transfusionnel ou trali

Despite its underrated incidence, transfusion-related acute lung injury (TRALI) is the leading cause of transfusion-related morbidity and mortality worldwide. The pulmonary edema in TRALI occurs in the course of the transfusion of apheresis products or erythrocyte concentrates. Its pathogenesis is attributed to the infusion of donor antibodies that recognize leucocyte antigens in the transfused host, with subsequent sequestration of leucocytes in the pulmonary vessels. It is also associated with the passive transfer of lipids and other biological response modifiers that accumulate during the storage or processing of blood components. The innate immunity and inflammatory kinins are key components. The knowledge of its etiopathogenesis must come into play for improving prevention and diagnosis and for application of adapted care of the patient.