半相合造血干细胞移植中发生的输血相关急性肺损伤:1例病例报告附文献复习  

Transfusion related acute lung injury occurred in HLA half-matched hematopoietic stem cell transplantation:a case report and literature review

作　　者：曾东风[1] 孔佩艳[1] 陈幸华[1] 张曦[1] 张江[1] 李杰平[1] 熊竹娟[1] 秦先念[1] 王庆余[1] 

机构地区：[1]第三军医大学新桥医院血液科,重庆400037

出　　处：《中国输血杂志》2009年第11期900-902,共3页Chinese Journal of Blood Transfusion

摘　　要：目的探讨HLA半相合造血干细胞移植过程中发生输血相关急性肺损伤(TRALI)的风险性及其处理、预防措施。方法对1名行HLA半相合造血干细胞移植治疗的患者在移植过程中出现的TRALI的临床发病特点、实验室检查、影像检查、治疗措施进行分析,并对相关文献做复习。结果发现该患者在移植过程中因输注机采新鲜血小板而导致TRALI,经积极抢救无效,最终病情恶化死亡。结论半相合造血干细胞移植过程中若反复输血(包括血液成分),存在发生TRALI的较大风险,积极有效的预防和及时的处理措施显得尤为必要。Objective To clarify the risk, treatment and preventive measurement of transfusion related acute lung inju- ry （TRALI） occurred in HLA half-matched hematopoietic stem cell transplantation. Methods A ease of TRALI occurred in HLA half-matched hematopaietic stem cell transplantation was analyzed, including the clinical characteristics, the labo- ratory and instrumental examination, the treatment measure and prognosis, and then the associated literature was reviewed. Results Owing to the blood products（fresh platelet） transfusion during transplantation, the patient got TRALI. And after active rescue, the patient eventually died due to the worsen condition. Conclusion The risk of TRALI is very high in HLA half-matched hematopoietic stem cell transplantation since the blood products transfusion is inevitable, so the effective and timely treatment and preventive measurement are necessary.

关 键 词：输血相关急性肺损伤(TRALI) 半相合造血干细胞移植 HLA 血液成分 输注 

分 类 号：R457.1[医药卫生—治疗学] R563.8[医药卫生—临床医学]