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Credit: Elise Amendola
Two studies shed new light on the prevalence of transfusion-related acute lung injury (TRALI) and transfusion-associated circulatory overload (TACO) in the US.
The research showed that postoperative TRALI is significantly underreported and more common than previously thought, with an overall rate of 1.4%.
And the rate of TACO is on the decline, but the risk to surgical patients remains high, at 4%, similar to previous TACO estimates in non-surgical patients.
“An accurate understanding of the risks associated with blood transfusions is essential when determining the safety and appropriateness of transfusion therapies for patients,” said Daryl Kor, MD, senior author of both studies and an associate professor at Mayo Clinic in Rochester, Minnesota.
“Our research provides a greater awareness of the incidence of TRALI and TACO in surgical patients, a population that has been perhaps underrepresented in studies in this area. We believe this to be an important first step in our efforts to prevent these life-threatening transfusion complications.”
Dr Kor and his colleagues described this research in Anesthesiology alongside a related editorial.
In the two retrospective studies, the researchers examined the incidence of TRALI in 3379 patients and TACO in 4070 patients who received blood transfusions during non-cardiac surgery under general anesthesia in 2004 and 2011.
Using a novel algorithm, followed by a rigorous manual review, the team performed a detailed epidemiologic analysis for both complications.
The first study showed that TRALI occurred in 1.4% of surgical patients, with higher rates in specific surgical populations such as those having surgery inside the chest cavity, on major blood vessels, or having an organ transplant. Patients who received larger volumes of blood were also at increased risk.
Previous studies investigating TRALI rates have primarily focused on the critically ill and reported variable incidence rates. Many studies have reported incidences between 0.02% and 0.05%.
The second study showed that TACO occurs in 4.3% of surgical patients, with higher rates associated with increased volume of blood transfused, advanced age, and total intraoperative fluid balance. Again, patients having surgery inside the chest cavity, on major blood vessels, or organ transplants were at the greatest risk.
The study also revealed that the rate of TACO decreased significantly from 2004 to 2011—from 5.5% to 3%. This decline was not fully explained by any of the patient or transfusion characteristics evaluated in the study.
The researchers said future studies are needed to further explore which mechanisms and risk factors are responsible for TACO and TRALI.
“With improved understanding of the mechanisms underlying TRALI and TACO, we may be able to refine the novel electronic algorithms used to screen patients in these studies,” Dr Kor said. “Ultimately, we hope to develop a real-time prediction model for these complications so that we can identify those at greatest risk and perhaps implement strategies to reduce this risk.” 
Credit: Elise Amendola
Two studies shed new light on the prevalence of transfusion-related acute lung injury (TRALI) and transfusion-associated circulatory overload (TACO) in the US.
The research showed that postoperative TRALI is significantly underreported and more common than previously thought, with an overall rate of 1.4%.
And the rate of TACO is on the decline, but the risk to surgical patients remains high, at 4%, similar to previous TACO estimates in non-surgical patients.
“An accurate understanding of the risks associated with blood transfusions is essential when determining the safety and appropriateness of transfusion therapies for patients,” said Daryl Kor, MD, senior author of both studies and an associate professor at Mayo Clinic in Rochester, Minnesota.
“Our research provides a greater awareness of the incidence of TRALI and TACO in surgical patients, a population that has been perhaps underrepresented in studies in this area. We believe this to be an important first step in our efforts to prevent these life-threatening transfusion complications.”
Dr Kor and his colleagues described this research in Anesthesiology alongside a related editorial.
In the two retrospective studies, the researchers examined the incidence of TRALI in 3379 patients and TACO in 4070 patients who received blood transfusions during non-cardiac surgery under general anesthesia in 2004 and 2011.
Using a novel algorithm, followed by a rigorous manual review, the team performed a detailed epidemiologic analysis for both complications.
The first study showed that TRALI occurred in 1.4% of surgical patients, with higher rates in specific surgical populations such as those having surgery inside the chest cavity, on major blood vessels, or having an organ transplant. Patients who received larger volumes of blood were also at increased risk.
Previous studies investigating TRALI rates have primarily focused on the critically ill and reported variable incidence rates. Many studies have reported incidences between 0.02% and 0.05%.
The second study showed that TACO occurs in 4.3% of surgical patients, with higher rates associated with increased volume of blood transfused, advanced age, and total intraoperative fluid balance. Again, patients having surgery inside the chest cavity, on major blood vessels, or organ transplants were at the greatest risk.
The study also revealed that the rate of TACO decreased significantly from 2004 to 2011—from 5.5% to 3%. This decline was not fully explained by any of the patient or transfusion characteristics evaluated in the study.
The researchers said future studies are needed to further explore which mechanisms and risk factors are responsible for TACO and TRALI.
“With improved understanding of the mechanisms underlying TRALI and TACO, we may be able to refine the novel electronic algorithms used to screen patients in these studies,” Dr Kor said. “Ultimately, we hope to develop a real-time prediction model for these complications so that we can identify those at greatest risk and perhaps implement strategies to reduce this risk.”
Credit: Elise Amendola
Two studies shed new light on the prevalence of transfusion-related acute lung injury (TRALI) and transfusion-associated circulatory overload (TACO) in the US.
The research showed that postoperative TRALI is significantly underreported and more common than previously thought, with an overall rate of 1.4%.
And the rate of TACO is on the decline, but the risk to surgical patients remains high, at 4%, similar to previous TACO estimates in non-surgical patients.
“An accurate understanding of the risks associated with blood transfusions is essential when determining the safety and appropriateness of transfusion therapies for patients,” said Daryl Kor, MD, senior author of both studies and an associate professor at Mayo Clinic in Rochester, Minnesota.
“Our research provides a greater awareness of the incidence of TRALI and TACO in surgical patients, a population that has been perhaps underrepresented in studies in this area. We believe this to be an important first step in our efforts to prevent these life-threatening transfusion complications.”
Dr Kor and his colleagues described this research in Anesthesiology alongside a related editorial.
In the two retrospective studies, the researchers examined the incidence of TRALI in 3379 patients and TACO in 4070 patients who received blood transfusions during non-cardiac surgery under general anesthesia in 2004 and 2011.
Using a novel algorithm, followed by a rigorous manual review, the team performed a detailed epidemiologic analysis for both complications.
The first study showed that TRALI occurred in 1.4% of surgical patients, with higher rates in specific surgical populations such as those having surgery inside the chest cavity, on major blood vessels, or having an organ transplant. Patients who received larger volumes of blood were also at increased risk.
Previous studies investigating TRALI rates have primarily focused on the critically ill and reported variable incidence rates. Many studies have reported incidences between 0.02% and 0.05%.
The second study showed that TACO occurs in 4.3% of surgical patients, with higher rates associated with increased volume of blood transfused, advanced age, and total intraoperative fluid balance. Again, patients having surgery inside the chest cavity, on major blood vessels, or organ transplants were at the greatest risk.
The study also revealed that the rate of TACO decreased significantly from 2004 to 2011—from 5.5% to 3%. This decline was not fully explained by any of the patient or transfusion characteristics evaluated in the study.
The researchers said future studies are needed to further explore which mechanisms and risk factors are responsible for TACO and TRALI.
“With improved understanding of the mechanisms underlying TRALI and TACO, we may be able to refine the novel electronic algorithms used to screen patients in these studies,” Dr Kor said. “Ultimately, we hope to develop a real-time prediction model for these complications so that we can identify those at greatest risk and perhaps implement strategies to reduce this risk.”