The nurse is caring for a patient who suddenly developed severe respiratory distress after a blood transfusion. The health provider makes the diagnosis of transfusion-related acute lung injury (TRALI)

Question

The nurse explains which implication of this diagnosis? 1. The patient can never have another transfusion again from any donor.
2. If transfusions are necessary, it will be important to use specially screened blood from which white blood cells have been removed.
3. The patient can never have another transfusion from the same donor.
4. Close family members of the patient should never have a blood transfusion.

Answer 1

3
Rationale 1: It is acceptable for the patient to have another transfusion from another donor.
Rationale 2: There is no indication that specially screened blood or blood with no white blood cells is required.
Rationale 3: The exact cause of this complication is not fully understood. One prevailing theory is that TRALI is caused by the presence of granulocyte antibodies and biologically active lipids in the donor plasma that the recipient reacts to. If antibodies are present in the donor's plasma, they stimulate the WBCs in the recipient's blood. Once TRALI has occurred, the recipient should not receive any more transfusions from the same donor.
Rationale 4: Family members should be informed, but this is not an indication that they should not have transfusions.