A recent awake on blood [published by the Jehovahs Witnesses] spoke about TRALI, I think the awake magazine brought out where it is because of an immune reaction or so between 2 or more blood types

does it involve the commonly recognised blood groups A, B, AB and O or some combination of the [maybe 400] antigenic markers on red blood cells [would need to check]

Hi everyone,
I have read about the TRALI-Transfuison-related acute lung injury on thie site and in the Awake but I don't understand it.I know blood transfusions cause lots of bad stuff to people.But how does blood transfusions causes lung injury.
Melissa Loyd

Dear Melissa,

I hope this answers your question...

TRALI (Transfusion Related Acute Lung Injury) is caused by an antigen-antibody reaction, but it’s not like an ordinary allergic reaction. In an allergy, the patient's own antibodies are reacting to a foreign antigen. In TRALI, the antibodies come from the blood donor. In other words, they're in the transfused blood that the patient receives. These are antibodies to human leukocytes (white blood cells), and once they're received by the patient through the transfusion, they attach to the patient's white blood cells and form microaggregates that end up in the lungs, where they can cause life-threatening vascular permeability and pulmonary edema (swelling and/or fluid accumulation in the lungs).

Some blood donors are more likely to carry these antibodies than others.
Women who've had multiple births, and people who've received previous transfusions, are thought to be more likely to have these antibodies.

It’s important to recognize TRALI in patients who recently received a transfusion. This means being alert to the kinds of symptoms you might expect after an antigen-antibody reaction in the lungs. So you'd watch for shortness of breath, hypoxemia, hypotension, fever, and severe bilateral pulmonary edema. They usually begin within one to two hours after the transfusion and they're fully present within six hours. Depending on the severity of the symptoms, patients may require respiratory support. Diuretics are not effective in treating TRALI, since the underlying pathology involves microvascular injury, not fluid overload. FDA Patient Safety News

Symptoms typically begin 1-2 hours after transfusion and are fully manifest within 1-6 hours. Products typically implicated in TRALI are whole blood, packed red blood cells, fresh frozen plasma, cryoprecipitate, platelet concentrates, apheresis platelets, and rarely IGIV1. The etiology of TRALI may be attributable to the presence of anti-HLA and/ or anti-granulocyte antibodies in the plasma of multiparous females or donors who have received previous transfusions. TRALI recipients have no specific demographics such as age, gender, or previous transfusion history. Although TRALI does not always occur through transfusions from donors with anti-HLA or anti-granulocyte antibodies, one or both of these antibody types have been found in 89% of TRALI cases.2 FDA Department of Health and Human Services


1 Rizk A, Gorson K, Kenny L, and Weinstein R: Transfusion-related acute lung injury after the infusion of IVIG. Transfusion 2001; 41:264-268.


2 Popovsky,MA, Chaplin, HC, and Moore, SB. Transfusion-related lung injury: a neglected serious complication of hemotherapy. Transfusion 1992; 32:589-592.

__________________
Sharon Grant
Editorial Team

3/2/2008: To Sharon Grant: Since these antibodies attach to white blood cells and mutate them, why wouldn't they be considered a form of cancer? They multiply so quickly(1-6 hours) it even sounds like they are cancerous-out of control-cells. What do you think? Has anything else been printed about it? Specifically. It sounds more like the info was general explanation.

This might serve to clarify your question about what is cancer.


Cancer

Cancer, in medicine, common term for neoplasms, or tumors, that are malignant. Like benign tumors, malignant tumors do not respond to body mechanisms that limit cell growth. Unlike benign tumors, malignant tumors consist of undifferentiated, or unspecialized, cells that show an atypical cell structure and do not function like the normal cells from the organ from which they derive. Cancer cells, unlike normal cells, lack contact inhibition; cancer cells growing in laboratory tissue culture do not stop growing when they touch each other on a glass or other solid surface but grow in masses several layers deep.

Article

Neoplasm

Neoplasm or tumor, tissue composed of cells that grow in an abnormal way. Normal tissue is growth-limited, i.e., cell reproduction is equal to cell death. Feedback controls limit cell division after a certain number of cells have developed, allowing for tissue repair but not expansion. Tumor cells are less responsive to these restraints and can proliferate to the point where they disrupt tissue architecture, distort the flow of nutrients, and otherwise do damage.

Original Article

__________________
Mr. Jan B. Wade
Blood Management Consultant
Enhance Outcomes - Control Cost
For Information Call - 360 296-1807
Email

3/15/2008: The links in Mr.Wade's reply above would not open. 21stCentury.

If your computer doesn't open links such as these simply right click the link and then click on properties. Here's what you get for the second one - http://www.encyclopedia.com/doc/1E1-neoplasm

Or you can right click and click on "copy link location" then paste that in your url window.

You can try the second first one.

Did the information help you 21st Century?

__________________
Mr. Jan B. Wade
Blood Management Consultant
Enhance Outcomes - Control Cost
For Information Call - 360 296-1807
Email

I could only guess that they wouldn't be called cancer (if that's the case) because they are antibodies and not whole cells. There are all sorts of things besides cancer which replicate rapidly to the disadvantage of the host body, like viruses, and I think protein/amyloid/etc plaques related to Alzheimers also do something like that even if they are 'only' proteins which are usually building blocks of life and not its impediments.

To have white blood cells corrupted and turned against you is even more contrary!

These antibodies do not mutate the patients' blood cells; they simply attach to them and in so doing, alter their function, just as if you attached a set of aluminum cans to your shoes by an extra lace. Makes normal ambulation, stair climbing, etc. really hard. Antibodies that don't belong on the cell impede the cell's usual function, if not actually leading to cell destruction; at least they would interfere with the body's normal way of utilizing or responding to those cells.

As Jan Wade has pointed out by his post, these are not cancerous cells. The pathophysiology is quite different. Cancerous cells replicate the way they do because for some reason the cells' normal "stop replication" signal fails to kick in, and the cells reproduce out of control. They use up tremendous amounts of the body's energy resources that would normally go to other tissues for metabolism. (This is a totally simplistic way of putting it, but just for purposes of differentiation...)

__________________
Jan Grossberg, RN, BSN
Editorial Team