The number one and two causes of blood transfusion-associated deaths in the U.S., transfusion-related acute lung injury and transfusion-related circulatory overload, may be more common or more risky than previously reported, according to two studies published in the January issue of Anesthesiology.
TRALI happens when air spaces in the lungs become inflamed and filled with fluid after the transmission. TACO happens in patients who are susceptible to fluid overload and receive a transfusion and have symptoms of heart failure.
In one study, researchers examined the incidence of TRALI in 3,379 patients who received transfusions during surgery. They found TRALI happens in 1.4 percent of surgical patients, with higher rates in patients who have surgery inside the chest cavity or major blood vessels or who have an organ transplant. Previous studies had found a much lower incidence rate, between 0.02 and 0.05.
In another study examining incidence of TACO in 4,070 patients who received blood transfusions found that TACO happens in 4.3 percent of surgical patients.
"Our research provides a greater awareness of the incidence of TRALI and TACO in surgical patients, a population that has been perhaps underrepresented in studies in this area," said Daryl Kor, MD, senior author of both studies and associate professor of anesthesiology at Mayo Clinic in Rochester, Minn. "We believe this to be an important first step in our efforts to prevent these life-threatening transfusion complications."