Skip Navigation LinksHome > Standards & Accreditation > Standard Setting Activities > AABB Revises and Clarifies TRALI Risk Reduction Requirements

AABB Revises and Clarifies TRALI Risk Reduction Requirements

AABB's Blood Bank/Transfusion Service Standards Program Unit, or BBTS SPU, with the approval of the AABB Board of Directors, has revised the transfusion-related acute lung injury, or TRALI, risk reduction requirements contained in the 29th edition of Standards for Blood Banks and Transfusion Services. The revised TRALI risk reduction standard reads as follows:

5.4.1.1.1 Plasma and whole blood for allogeneic transfusion shall be from males, females who have not been pregnant, or females who have been tested since their most recent pregnancy and results interpreted as negative for HLA antibodies.
In a Weekly Report article published on Aug. 16, 2013, AABB first presented a series of TRALI risk reduction standards to its members. These standards, which were explained in greater detail in a related communication piece, required that high plasma volume components be collected from males, never pregnant females, or previously pregnant females who have tested negative for HLA antibodies since their most recent pregnancy. A definition of the phrase "high plasma volume components" was included, and a note in the communication piece indicated that, at the time of writing, Apheresis Platelets collected in a platelet additive solution, or PAS, were exempted from TRALI risk reduction requirements.

The AABB Board of Directors and Executive Office received extensive feedback regarding the PAS exemption from standard 5.4.1.1.1. Much of this feedback expressed concern about the volume of plasma that remains in platelets collected in PAS. In response to this feedback, the AABB Board of Directors requested that the BBTS SPU re-evaluate TRALI risk reduction standards in the 29th edition, particularly with regard to platelet products. In response to the request, the BBTS SPU revised standard 5.4.1.1.1 to address plasma and whole blood. The AABB Board of Directors has charged AABB's TRALI Work Group with reviewing the available scientific data on the role of all TRALI risk reduction measures with respect to platelets including the use of platelet additive solutions. The board will keep the membership informed of any new developments, including the possible need for an interim standard to address TRALI risk reduction in platelet components.