The government and researchers are warning that blood transfusions can cause a serious and often-unrecognized lung problem that has been linked to more than 50 deaths nationwide since 1990. About 8 million people donate blood and about 4.5 million patients receive transfusions each year. Testing for the antibodies in donated blood is difficult and not part of routine screening of the nation's blood supply.
The condition - transfusion-related acute lung injury, or TRALI - is believed to be caused in most cases by an immune-system reaction to antibodies in the donor's blood. Though it produces lung damage that is generally reversible, TRALI is a leading cause of death for transfusion recipients. It kills 5% to 10% of patients who develop it. Doctors believe it is underreported because its symptoms - including shortness of breath, fluid buildup in the lungs and low blood pressure - mimic those of other ailments.
The FDA sent a letter to transfusion specialists nationwide describing TRALI and warning that "recognition of symptoms and immediate treatment are imperative." The FDA said that it has received reports of more than 50 TRALI deaths since 1990, but that the full scope of the problem is unclear because of misdiagnosis or underreporting.
These conditions are routinely treated with diuretics, or drugs that decrease body fluid by increasing urine production. But diuretics can be dangerous and even deadly for TRALI patients, who need more fluids.