Level of pro-inflammatory cytokines in patients with transfusion-related acute lung injury - Multiple comparisons between patients, controls and donor

Abstract

Transfusion-related acute lung injury recently regarded as the leading cause of death after transfusion. Several pro-inflammatory cytokines TNF, IL6 and IL8 have been linked to the pathogenesis of TRALI, supported by the findings of increased their serum levels in recipient patients. This is a prospective case-control study, twenty-five patients with a diagnosis of TRALI after transfusion of blood products were included and compared to another 25 transfused patients. Serum was obtained after the onset of TRALI in patients and controls. Other samples were obtained from the saved donor transfused bag or segments. All samples were utilized for cytokines assay. The intubation rate among TRALI patients was 48%. No difference was found in the regarding the type of transfusion and the cytokine level for each specific type of blood or blood component transfused between TRALI and controls. The over- all TRALI associated mortality was 4%. Results revealed significantly increased TNF alpha IL-6 levels in sera of TRALI patients as compared with control and donor unit for patients with TRALI. Serum levels of IL-8 were significantly higher in patients with TRALI (mean 42.11 pg/ml) as compared with sera of control and donor unit for TRALI patients. Serum level of TNF, IL-6 and-8 in patients with TRALI was significantly higher in patients with longer incubation time. Serum cytokines assay in patients with TRALI may add the significant advantage of assessing the severity, associated mortality and predicting the time of ventilator support.