Misconceptions about TRALI Risk Reduction Recommendations:
Female Plasma Usage
AABB, America’s Blood Centers and the American Red Cross have received inquiries from the media and the public concerning blood center use of plasma according to the gender of the donor. A recent AABB Association Bulletin suggested that in order to reduce the incidence of transfusion-related acute lung injury (TRALI), plasma from female donors would be preferable for use in the preparation of life saving medications, while plasma for transfusion should come predominantly from male donors.
Unfortunately, some press articles have misinterpreted these recommendations. Such articles have given the impression that blood donations by women are not as vital as donations made by men. These statements are incorrect because they do not emphasize that women blood donors are just as essential for the maintenance of a healthy blood supply as are donations from male donors. The fact is that donations made by women account for half of the blood supply and save as many lives as donations made by men.
In order to fulfill the recent AABB recommendation and reduce the risk of TRALI, each blood center in the United States will need to determine the best way to ensure that appropriate units of blood and components are selected for transfusion.
About TRALI
TRALI is most commonly caused by a reaction to leukocyte antibodies present in the plasma component of blood products. These antibodies can activate granulocytes that cause plasma leakage into the lungs, resulting in acute pulmonary edema. According to the Food and Drug Administration, TRALI is a leading cause of transfusion-related deaths in both male and female patients. The implicated components in TRALI reactions are usually associated with female donors who have had one or more pregnancies or any donor who has been previously transfused. Women are more likely than men to have antibodies to leukocytes due to exposure to fetal antigens during pregnancy. There is currently no screening test for the prevention of TRALI and there is no single intervention that can eliminate the risk of TRALI.