Lieberman et al listed a number of conditions that must be excluded before the diagnosis of transfusion-related acute lung injury (TRALI) can be made. The authors are from University Health Network Toronto, University of Toronto, University of British Columbia, Sunnybrook Health Sciences Center Toronto and the Canadian Blood Services Ottawa in Canada.
Conditions to exclude before making the diagnosis of TRALI:
(1) cardiac overload
(2) causes of direct lung injury unrelated to blood product transfusion
(2a) aspiration
(2b) infectious pneumonia
(2c) toxic inhalation
(2d) lung contusion
(2e) near-drowning
(3) causes of indirect lung injury unrelated to blood product transfusion
(3a) sepsis
(3b) shock
(3c) multiple trauma
(3d) thermal/burn injury
(3e) acute pancreatitis
(3f) cardiopulmonary bypass
(3g) lung overdose
(4) exacerbation of a pre-existing lung disease (asthma, COPD, etc)
(5) pulmonary embolism
If one or more of these conditions are present then either:
(1) the patient does not have TRALI (pseudo-TRALI)
(2) the patient has a mixed condition (TRALI plus something else)
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