Transfusion-related acute lung injury.

With the success of reducing the risk of transfusion-transmitted infectious diseases, noninfectious serious hazards of transfusion have come to the forefront with respect to transfusion safety. Transfusion-related acute lung injury has emerged as a dominant noninfectious serious hazard of transfusion. Improved understanding of its pathophysiology is needed to improve clinical strategies to deal with the risk. Such understanding, in turn, will depend on the continued progress in development of good model systems, in vitro and in vivo, for experimental studies. As the pathologic mechanisms are elucidated, a universal definition and strategies for the prevention and/or mitigation may become more tangible. This article reviews the clinical manifestations, evolving definition, incidence, pathophysiology, animal modeling, and donor screening and deferral algorithms as they relate to transfusion-related acute lung injury.