Transfusion-Related Acute Lung Injury
Imaging findings
Chest CT and radiographs in a patient with polycythemia vera who received a platelet transfusion show rapid development of diffuse, bilateral ground-glass opacities and mild interlobular septal thickening, with relative sparing of the apex. A follow-up radiograph obtained 24 hours later shows dramatic clearing.
Key takeaways
Transfusion-related acute lung injury (TRALI) is a form of non-cardiogenic pulmonary edema characterized by capillary leak following blood product transfusion (especially platelets or plasma). It is mediated by donor antibodies reacting with recipient granulocytes. Classically, it presents as acute respiratory distress within 6 hours of transfusion, and the edema characteristically clears within 24-48 hours.
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